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Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Differentiators
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Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details
Prior Authorizations
Prior Authorizations

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Categories

Solutions

Description

Product Description:

Improve patient access by accelerating time to care while reducing FTE resource spend on manual, repetitive tasks involved with obtaining prior authorizations.

About Adonis:

Adonis fosters unparalleled revenue outcomes that improve efficiency, reduce costs, and increase revenue. Our partnerships are forged in the commitment to long-term financial success. Whether you're a provider with an internal billing team or you outsource your RCM operation, we're prepared to meet you where you are to improve your billing and collections outcomes.

Product Description:
There’s a wealth of powerful data within your EHR—you just need real-time insights and seamless integration to make it actionable. Our Prior Authorization solution, powered by Waystar’s Hubble: - Automatically verifies, initiates, statuses and retrieves comprehensive authorization details - Enables efficient, intelligent automation by initiating authorizations at twice the speed of manual processes - Integrates directly with all major HIS and PM systems - Provides end-to-end authorization platform, including authorizations submissions for unscheduled admissions, as well as auto-generating ABNs or Notice of Non-coverage forms for Medical Necessity - Adapts to constantly shifting payer rules and requirements - Was built and is maintained by our in-house team of experts
About Waystar:

Waystar delivers innovative technology that simplifies and unifies healthcare payments. The company’s cloud-based platform helps healthcare providers across all care settings streamline workflows, improve financial performance and bring more transparency to the patient financial experience. Waystar solutions have been named Best in KLAS or Category Leader by KLAS Research 16 times (across multiple product categories) and earned multiple #1 rankings from Black Book. The Waystar platform is used by more than half a million providers, 1,000 health systems and hospitals, and 5,000 payers and health plans—and integrates with all major hospital information and practice management systems. On an annual basis, Waystar’s AI-powered solutions process $5B in patient payments, generate $4B in out-of-pocket estimates and process claims representing approximately 40% of the U.S. patient population. For more information, visit www.waystar.com.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Product Capabilities

Adonis’ Automated Prior Authorizations integrates with providers’ appointment systems to automatically review all upcoming appointments and identify those that will require prior authorization. Adonis uses a combination of machine learning and expert input to keep payer rules up to date, ensuring that all relevant appointments receive a prior authorization.

Adonis leverages machine learning and expert input to continually update its knowledge base. Adonis leverages AI to automatically identify and store payer rule updates.

Adonis’ prior authorization specialists use Adonis’ proprietary work list and form completion tools to more accurately and efficiently submit requests to the relevant payers. The speed and precision enabled by these automations lead to faster and higher rates of approvals.

Adonis’ prior authorization specialists use Adonis’ proprietary work list and form completion tools to more accurately and efficiently submit requests to the relevant payers. The speed and precision enabled by these automations lead to faster and higher rates of approvals.

Adonis’ prior authorization work list and form completion tooling allow for flexible document attachments, ensuring that all necessary information for receiving approval can be easily found and submitted.

Once Adonis identifies that prior authorization is required, the upcoming visit will enter our team’s work list. From there, our team members will prioritize prior authorizations based on service date.

The Prior Authorization Status Dashboard enables status tracking for all prior authorization requests.

Use Cases

Description:

Adonis’ Automated Prior Authorizations identifies scheduled patient visits that require authorizations by utilizing existing stored payer rules. Your staff is notified when authorizations are complete, denied, or require additional information not readily available within your system. All authorization data is pushed back to your system of record.

Pediatric use cases:

Adonis' Automated Prior Authorization is applicable across many specialty areas, including pediatrics;

Users:

Front-desk staff, Revenue Cycle Management Team

Description:

With over 300+ payers and a broad array of deployable service lines and patient types, we provide a full cycle automation solution for prior authorization: from pre-scheduled prior auth submission, status checking and denial prevention worklist alerts, as well as medical necessity verification and notification of admission.

Pediatric use cases:

None provided

Users:

Pre-service financial clearance teams, auth cert teams, any prior authorization staff doing medical necessity as well as authorization for services at acute care facilities or OP areas.

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

NextGen, athena, eClinicalWorks

Hardware Compatibility:

Desktop, Mobile / Tablet (web optimized), Mobile / Tablet (native app)

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Client Types

None provided

Differentiators

Differentiators vs EHR Functionality:
  • Fully Outsourced - Adonis handles all of the Prior Authorization workflows for your team and pushes the data back to the necessary systems
  • Highly automated - Prior Authorizations are performed behind the scenes with minimal intervention from staff
  • Machine Learning Backed Automations - Our machine learning models are trained on your Prior Authorization data, leading to efficiency gains and greater automations over time
Differentiators vs Competitors:
  • Adonis automates the bulk of authorization tasks, allowing your staff to prioritize high-value work and complex follow-ups.
  • Adonis maintains up-to-date payer rules, eliminating the need for staff members to regularly visit payer sites or commit guidelines to memory.
  • Adonis leverages machine learning to deliver exponentially increasing efficiency gains over time.
Differentiators vs EHR Functionality:
Many hospitals, health systems, and IDNs have invested in billion dollar EMR/EMRs which are an extraordinary vehicle for clinical and billing functions -- but lack the ability to elevate automation in key business areas such as prior authorization. This is due to their lack of payer connections and the absence of advanced intelligent software. Together, Waystar brings the intelligence that powers today's EMR/EHR platforms and automation efforts.
Differentiators vs Competitors:
With nearly a decade in the business of automating prior authorizations, we are known for our internal expertise when it comes to payers, process change, and technology. We believe pushing the envelope in know-how across all 3 is what gives our clients the edge on automation. With more payer connections, more relationships with payers, and greater flexibility in accessing payer data we can access the best and most timely data. We not only seamlessly integrate with EPIC but offer full-stack integration capabilities or a powerful stand-alone application -- all because each patient access team is different. And powered across our Hubble platform (a blend of RPA, machine learning, NLP, and advanced auth rules) we are well positioned to power your automated enterprise.

Keywords

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Company Details

Founded in 2000

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