MCG Health Partners with Healthx to Provide Expedited Prior Authorizations for Payers and Providers

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Integrated solution automates the prior authorization process to help ensure the efficient delivery of quality care.

MCG

MCG

MCG is proud to partner with Healthx to provide mutual clients a tool that aligns care delivery and clinical documentation with the best available evidence. This integration helps providers and payers achieve almost immediate ROI while proactively moving people toward health.

MCG Health, part of the Hearst Health network and a leading provider of informed care strategies, has partnered with Healthx, Inc., the leader in cloud-based digital engagement solutions for healthcare payers, to offer a streamlined authorization solution. This integration combines MCG’s evidence-based care guidelines and Cite AutoAuth workflow rules engine with Healthx’s easy-to-use Hx Authorization Submission solution. Designed to increase collaboration between payers and providers, this solution will automate the prior authorization process while maintaining decision quality, empowering clinicians to deliver effective care in a timely manner.

Payers typically require prior approval for certain procedures and services to ensure appropriate care while managing costs and avoiding overutilization. MCG Cite AutoAuth integrated within Hx Authorization Submission allows for automatic determinations for select procedures and services as determined by the payer. Payers can configure a custom rules-based engine to prevent unnecessary prior authorizations and apply evidence-based documentation where appropriate—saving time and improving standards of care.

Seamless integration between the two platforms allows providers to document and support treatment requests directly within the care planning workflow in an easy three-step process. Providers have the option to add multiple procedures to one request, attach documentation for auto-approval consideration, and track the status of previously submitted requests. Replacing a high-touch, manual process with this innovative solution decreases the number of authorizations that require review, eliminates the need for faxes, and significantly reduces time spent waiting on determinations.

“Through this solution, providers can access clinical guidance for treatments and have transparency into what payers require for approvals. This simplifies the documentation process and allows providers to receive approvals in a matter of seconds,” said Mike Gordon, Chief Strategy and Alliances Officer for Healthx. “In addition to creating efficiencies and cost savings for payers and providers, automating the authorization process frees up time for providers to spend with patients and reduces scheduling delays that can impact patient health and satisfaction or even cause patients to opt out of medically necessary treatments.”

“MCG is proud to partner with Healthx to provide mutual clients a tool that aligns care delivery and clinical documentation with the best available evidence,” said Jon Shreve, President and CEO of MCG Health. “This integration helps providers and payers achieve almost immediate ROI while proactively moving people toward health.”

About Healthx
At Healthx, we put our nearly 20 years of industry experience and best practices to work to serve the needs of approximately 200 healthcare payers representing 24 million members and 700,000 providers. We develop and implement secure, cloud-based member-centric digital portals that connect payers with members and providers. We partner with commercial health plans, third-party administrators, employers and brokers to build comprehensive, configurable solutions that improve clinical, operational and financial performance. Through our platform, our customers can close gaps in care, achieve regulatory compliance, improve quality ratings and reduce costs. Our customers achieve a rapid return on investment by moving more transactions from costly channels to efficient online portals. For more information, visit http://www.healthx.com. Follow Healthx on Twitter, LinkedIn and Facebook.

About MCG
MCG, part of the Hearst Health network, helps healthcare organizations implement informed care strategies that proactively and efficiently move patients toward health. MCG’s transparent assessment of the latest research and scholarly articles, along with our own data analysis, gives patients, providers and payers the vetted information they need to feel confident in every care decision, in every moment. For more information, visit http://www.mcg.com or follow our Twitter handle at @MCG_Health.

About Hearst Health
The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, MedHOK, Hearst Health International, Hearst Health Ventures and the Hearst Health Innovation Lab (http://www.hearsthealth.com). The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person's health journey. Each year in the U.S., care guidance from the Hearst Health network reaches 84 percent of discharged patients, 177 million insured individuals, 60 million home health visits, and 3.1 billion dispensed prescriptions.

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Arri Burgess
MCG Health
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Sean Reiter
Healthx
317 218 0609
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