Inpatient Authorization Requests through Clear Coverage
Texas Children’s Health Plan is excited to announce the upcoming implementation of Clear Coverage for inpatient authorization requests beginning May 1, 2017. Clear Coverage is a web-based system that provides an automated method for providers and health plans to manage authorizations for inpatient services at the point of decision. Clear Coverage enables automated authorization, notification, eligibility and direction of members to in-network service providers. Clear Coverage provides the following benefits:
- Providers have immediate access to coverage, medical appropriateness and network rules, driving the consistent application of evidence based medicine.
- Providers have transparency into the evidence based medical necessity.
Allows for Health Plans to do exception based UM and only touch those requests that do not meet medical necessity. - Secured PHI transmission
- Scanning and attaching only required elements from the medical record, reducing the need to print and fax.
- Faster turnaround times
- Due to an instant decision based on medical necessity, when applicable.
- Eliminates need for numerous call backs when clinical is attached to the request.
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