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Value Health

One Connected Workflow from eBV to ePA

Value Health connects eBV results with end-to-end electronic prior authorization (ePAorchestration bringing payer workflows, HCP outreach, hub operations, and patient services CRM into one trackable PA process. Complete requests move electronically where supported. Fax, phone, payer portal, incomplete packets, and ambiguous responses are managed through omnichannel workflows and human-in-the-loop resolution. 

Automation moves routine requests. Experienced teams resolve the exceptions. 

Activate ePA Directly from the eBV Response

When eBV identifies a PA requirement, Value Health activates the next workflow with: 

PA and step therapy requirements
Payer-specific criteria
Required fields and clinical documents
Existing authorizations on file
Appropriate forms and submission routes
Missing information requiring HCP action

One benefit check. One connected path to action. 

One Orchestration Layer for the Entire PA Lifecycle

Discover

Identify PA requirements, step therapy rules, payer criteria, and existing authorizations.

Prepare

Populate required fields using existing CRM data and prepare the appropriate form from 500+ preconfigured PA forms covering top payers.

Complete

Route missing clinical information, documents, and attestation requests to HCPs through web forms, fax, email, or phone.

Track and Act

Monitor status every eight hours and return approvals, denials, authorization details, and next actions directly to the CRM.

Submit

Submit electronically where available, with support for fax, phone, and payer portal workflows.

One Orchestration Layer for the Entire PA Lifecycle

Discover

Identify PA requirements, step therapy rules, payer criteria, and existing authorizations.

Prepare

Populate required fields using existing CRM data and prepare the appropriate form from 500+ preconfigured PA forms covering top payers.

Complete

Route missing clinical information, documents, and attestation requests to HCPs through web forms, fax, email, or phone.

Track and Act

Monitor status every eight hours and return approvals, denials, authorization details, and next actions directly to the CRM.

Submit

Submit electronically where available, with support for fax, phone, and payer portal workflows.

From ePA Status to Next-Best Action

PA Outcome Structured Output Next Action
PA Required Criteria, documents and submission route Initiate PA workflow
Information Missing Missing fields and required HCP action Route for completion
Submitted Confirmation and payer reference Begin monitoring
Pending Current status and elapsed timeline Escalate when required
Decision Returned Approval or denial, PA number, dates and reason Update CRM and route the case

Keep Every PA Moving Toward a Decision

Connect eBV, PA preparation, submission, status monitoring, exception handling, and decision routing in one integrated workflow.

Connect Your eBV and ePA Workflows