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Pre Authorization, Experian, and SIU Interface

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Last Post by gibsonmi 4 years ago

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ntaylor

(@ntaylor)

Posts: 79

Estimable Member

Topic starter

Hi,

Has anyone used Experian/Passport's Pre-Authorization Management product with CPS/athenaPractice?

We are a multi-specialty physician group, and also have our own Imaging & Lab Facilities, and are looking for a way to streamline our Pre-Authorization process for all our surgeries, imaging, and other procedures/services we provide. It's my understanding that we have a few different workflows for performing pre-authorizations. Some information comes from a Centricity schedule, some from our RIS schedule, some from EMR Orders, etc., etc.

We are looking at implementing the Experian solution, and in our demo they mention the way they normally integrate their produce with the billing system, is by receiving an SIU Appointment message, which also contains the CPT Code information.

I have not seen anywhere in the CPS Schedule settings, where you can setup or select specific CPT Codes associated with an appointment.
I've looked through the Centricity interface documentation and see where the SIU message does have a segment that can include the "Patient Visit" information for that appointment, but it does not look like it includes CPT and Dx Code information for that visit.

I'm curious if others are using this Experian product or something similar for your Pre-Authorizations, and if so, do you have any guidance regarding workflow, interfaces, and how you are capturing and sending the needed CPT and other information to the third party system.

Thanks in advance.

Posted : June 7, 2020 8:27 pm

gibsonmi

(@gibsonmi)

Posts: 827

Prominent Member

Just wondering if you moved forward with this or any other product. We are a single specialty that relies heavily on pre-auths and its currently a manual process. Thanks

Posted : August 12, 2020 12:14 am

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