August 7, 2023
It's a solution that will allow a more secure and efficient data exchange between providers and health plans.
Wellcare now uses Epic Payer Platform’s efficient bi-directional data exchange, between providers and health plans, as part of our broader interoperability strategy.
Epic Payer Platform benefits providers by:
- Allowing digital submission of clinical documents
- Saving time and administrative overhead expenses
- Combining knowledge to improve care, and
- Improving the patient experience with a more complete medical record on hand
This platform is available for health systems and providers on Epic.
What are the features of Epic Payer Platform?
Epic Payer Platform automatically releases appropriate clinical records to health plans. This helps reduce manual record requests, reducing administrative burden for providers. Our first use case covers risk adjustment submissions. Additionally, Wellcare intends to include use cases around Healthcare Effectiveness Data and Information Set (HEDIS®) measures and quality. By receiving information from Epic Payer Platform, accuracy and quality will improve.
Wellcare intends to develop additional features in the future and continue to refine our roadmap, such as:
- Actionable insights (such as on our members’ gaps in care and historical conditions and diagnoses) that can be provided at the point of care directly into a clinician’s existing workflow. This helps providers receive a more complete picture of their patients to help improve their quality of care.
- Plans to pilot prior authorization can help streamline the process and further reduce administrative friction.
This update applies to Independent Practice Associations and Hospitals.