Release 8.12

Release date: September 30, 2022

Check provider status

Payers can now configure Eviti Connect to check whether the provider that entered the treatment plan is participating, sanctioned, or terminated.

  • Added new configuration to check the submitting provider against the provider file (#123699).
  • Added new analyzer deviation trigger, flag, and message when the provider is non-participating, sanctioned, or terminated (#123700).
  • Added the patient’s address (via mouse over) and now display the provider’s name in red when the provider is non-participating, sanctioned or terminated (#123730).
  • Modified the medical office dashboard to let the medical office team process treatment plans associated with non-participating, sanctioned, or terminated providers (#124410).
  • Added new delegated entity letter types for treatment plans associated with a non-participating, sanctioned, or terminated provider (#127371).

Allow retroactive authorizations

Payers can now let users enter retroactive treatment plans.

  • Added a new configuration that determines how far in the past a user can change the start date for a submitted treatment plan (#125286).
  • Added a new analyzer deviation trigger, flag, and message when the user enters a start date that is outside the approved timeline (#125288).
  • Modified the screen order in the treatment plan entry workflow. After the Diagnosis screen (and any justifications) screens appear as follows: Site of Service (if configured), Treatment Start and End Date, and then the Deviation screen (also known as the Attach Medical Records screen) (#125287).
  • Modified the Complete MO Review screen if a treatment plan deviates due to an unacceptable retroactive authorization date. Retro Authorization Denial was added to the following drop-down menus: Compliant with Policy, Compliant with EBM, and Peer to Peer (#125492).
  • Added a new delegated entity letter type to support Retroactive Authorization Denials (#125496).

Assign authorization IDs

Payers can configure Eviti Connect to associate an authorization ID to treatment plans or specific drugs in a treatment plan (#128364).

  • For medical oncology (chemotherapy) treatment plans, the system generates a nine-character alphanumeric authorization ID that starts with the letter E, and associates the ID to all the drugs (approved and/or rejected) in the treatment plan (#125265 & #125271).
  • For radiation therapy treatment plans, the system generates a a nine-character alphanumeric authorization ID that starts with the letter E, and associates the ID at the treatment-plan level (#125262 & #125268).
  • The system displays the authorization IDs on the treatment plan summaries in the Patient Management, Provider, and Payer dashboards (#125278). Dashboard users can search by authorization ID via a new filter (#125313).
  • Updated the delegated entity letters to include the authorization IDs associated to the treatment plans and the treatment plan details (#125282).

Exclude providers from treatment plan entry

Payers can configure Eviti Connect to identify providers that are not required to submit treatment plans for preauthorization (#125722). If identified, the system displays a configurable message on the Patient Entry screen that notifies the user that they do not have to submit a treatment plan, and the Save Patient and Continue button is disabled (#125513).

Prevent users from entering chemotherapy or radiation treatment plans

Payers can prevent users from entering a chemotherapy or radiation treatment plan if they don’t support it. Added a new configuration, which includes a custom message (#125509). Modified the workflow to prevent entry of the treatment plan (#125630).

Partial treatment plan approval updates

Modified the Review Summary area of the Patient Management, Provider, and Payer dashboards. The dashboards now display the Eviti Review Notes tabs for partially-approved treatment plans, and includes the approved and rejected drug details. The Medical Office Summary link also appears in the Documents tab for partially approved treatment plans (#127158).

On the Partial Approvals Screen (#127154), changed the Internal Notes label to Clinical Review Notes. Clinical review notes for partially-approved treatment plans are now optional. Removed Yes and No options from the peer-to-peer drop-down list and replaced them with all of the peer-to-peer outcome options.

Physician credentials

If a NantHealth physician denies a treatment plan, the physician’s credentials are now an option on the Complete Medical Office review screen and throughout Connect, including the Review Summary and Appeals Summary tabs on the dashboards (#123866).

Resolved Issues

  • Terminating a HCPC code automatically terminates the active NDCs mapped to it (#126996).
  • AIM: Inactive clinical trial is available on enter patient page (#127100).
  • Non-pathway regimens showing in regimen as being pathway (#127038).
  • Server error when trying to view Diagnosis / Treatment Plan for records with status ‘Finalized: No Eviti Prior Authorization Required’ (#127615).