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For over fifteen years, our customers have depended on us for our Business Process Applications to automate their mission critical business processes. [Learn more]
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Health Pharmacy


Pharmacy Prior authorization requests represent physician requests for pre-approval for a specific prescription, prior to the prescription's being filled. Pharmacy Prior authorization requests are currently submitted by fax (predominantly), phone or electronically via portal. The most important driver is processing cycle time. The need for the prescription is immediate and all prior authorization requests must be processed immediately.

Fax requests are pulled of local machines and sorted (sometimes more than one authorization is submitted in a single fax), and distributed. If a request cannot be resolved at the first level of review by a knowledge worker it is manually routed to the next level. At the conclusion, authorizations are approved or denied via letter.


The IPD Solution
Ultera automatically manages the receipt of faxes and portals from multiple locations to prevent loss and accelerate the process. Once a Prior Authorization request is initiated, Ultera automates work assignments and priorities based on business rules and Service Level Agreements for each piece of work.

Ultera's Intelligent User Interfaces provide familiar, status-based methods for automatically referring requests to the next step in the process with a few simple mouse clicks. And because the entire work process is managed electronically, member and provider status inquiries can be answered accurately and immediately.

In combination, the features of Ultera ensure that prior authorization requests are resolved within the shortest timeframe possible, in compliance with regulatory and Serve Level Agreement requirements - and without keeping your customers waiting for their prescriptions. From start to finish, IPD Ultera provides a comprehensive content management and automated workflow solution for processing the complete lifecycle of Pharmacy transactions, including difficult-to-manage prior authorization requests.