Aligning Doctors & Payers

A Better Connection

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Efficient communication between physicians and payers is becoming more critical than ever, especially when it comes to cancer care. For patients, the timing and type of cancer treatments hang in the balance until a prescribed plan is reviewed and approved, so an expeditious connection is no trivial matter.

With 32% of treatment plans deviating from evidence-based medicine and the average cost per cancer treatment now exceeding $135,000, physicians and payers need to have confidence that prescribed treatments meet clinical requirements to ensure quality care and timely reimbursement.

Thanks to a new, comprehensive, oncology clinical decision support platform called eviti, two critical workflow paths have now been seamlessly integrated to align the interests of physicians, payers and patients. eviti 3.0 combines two powerful tools – eviti | Advisor for clinical decision support and eviti | Connect for pre-authorization and real-time treatment plan validation.

Once a physician has determined the appropriate treatment plan through eviti | Advisor, their administrative staff can be electronically notified to complete the precertification process via an integration with eviti | Connect. Through online precertification and pre-notification, oncology practices can quickly access an eviti code and know they are “on the same page” with payers. The latest version of eviti | Connect (3.0) has several enhancements including fewer clicks to an eviti code, a simplified treatment plan search, and a new, single-screen view of all available drugs in a particular treatment plan. eviti is accessible from any web-enabled device and includes 120+ cancer types, over 1,200 treatment regimens and 9,000+ clinical trials.

Clicking on any regimen will provide the user with more details including the supporting organizations, reference citations, disease free survival rates and toxicities. If a compliant, evidence-based treatment plan is selected, the user will receive an eviti code, which provides automated precertification and streamlined reimbursement.

eviti has been deployed to over 2,000 oncology practices, representing 40% of all oncology practices nationwide, and on average, deviations from evidence-based medicine have dropped from 35% to less than 10%.

Mark D. Rasche


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