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Avrio Corporation Success Story
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MedImpact is a transparent Pharmacy Benefits Management (PBM) company, focused on delivering value by providing flexibility and choice. The organization provides straightforward, cost-efficient and clinically effective prescription drug management for their clients. MedImpact currently services 27 million members nationwide, with clients that include Fortune 500 employer corporations, unions, managed care organizations, health plans, insurance carriers, third-party administrators, as well as local, state and federal employee programs.
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The Problem
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Pharmacy Benefits Management organizations use the Prior Authorization process to obtain approvals for patients to receive medications that are not directly covered by their insurance policies. For MedImpact, this process involved receiving and routing Medicine Request Forms (MRFs) to internal processing teams via fax and communicating requests to external processing teams via email. The process was time-consuming, and did not allow MedImpact to easily communicate tasks, retrieve and route information or analyze the productivity of both the process and its participants. Because of the time-sensitive nature of Prior Authorization requests, MedImpact approached Avrio Corporation to optimize this process.
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The Solution
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Avrio Corporation developed a solution that automated MedImpact’s Prior Authorization process and saved the organization time and money. In creating the solution, Avrio utilized industry-leading tools such as Kofax Ascent Capture and FileNet’s P8 Business Process Management, Content Management, eForms and Rendition products.
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Avrio used Kofax Ascent Capture to automate MedImpact’s indexing process by releasing Medicine Request Forms into a FileNet Content Manger Repository, where information is stored and can be readily retrieved. Avrio also utilized FileNet’s Process Engine tools to further optimize business processes, calculating due dates based on MedImpact’s Client Service Level Agreements, and alerting users to urgent tasks as critical dates approach. Both internal processing teams and external client teams benefit from automatic alerts, eliminating the need to send adhoc communications or uncontrolled emails.
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Avrio also developed an eForm User Interface that allows MedImpact to easily access all content associated with work items such as MRFs, guidelines, and correspondence. The eForm User Interface was integrated with a FileNet process engine and MedImpact’s Oracle-based Medical System. The eForm User Interface also enables staff to select MS Word correspondence templates with associated reason codes to generate outbound correspondence. Once accepted by the end user, the correspondence is converted to a PDF, using FileNet’s Rendition Engine, and is either automatically printed or faxed. Finally, Avrio utilized FileNet’s Process Analyzer tools to improve the prior authorization business management process, by creating productivity and work-in-process reports that allow MedImpact to measure the success of the entire process.
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