Pilot Configuration
Confirmed facts and unresolved assumptions for the next Keenan/Kevin validation session. Capture answers live to update requirements.
Synthetic demonstration environment. All patients, providers, payers and policies are fictional. Do not enter real patient information. This is not clinical guidance and not evidence of coverage or payment.
Current Provider / Order SourceSystems
To Be Confirmed During Domain Validation
AdvanceMDSystems
To Be Confirmed During Domain Validation
AdvanceMD API / Interface CapabilitySystems
To Be Confirmed During Domain Validation
Current LISSystems
CrelioHealth
First Pilot LISSystems
CrelioHealth
CrelioHealth Connection StatusSystems
To Be Confirmed During Domain Validation
CrelioHealth API / Interface CapabilitySystems
To Be Confirmed During Domain Validation
CrelioHealth Technical ContactSystems
To Be Confirmed During Domain Validation
Future / Planned LISSystems
To Be Confirmed During Domain Validation
Specific INVOPAD Product / ModuleSystems
To Be Confirmed During Domain Validation
INVOPAD Transition TimelineSystems
To Be Confirmed During Domain Validation
Billing / RCM PartnerSystems
PayMedics
PayMedics Billing Data SourceSystems
Receives billing information from CrelioHealth
Technical Method (CrelioHealth → PayMedics)Systems
To Be Confirmed During Domain Validation
PayMedics Electronic Outcome Return (claim/denial/payment)Systems
To Be Confirmed During Domain Validation
Medicare GeographyPayer
Texas
Medicare MACPayer
Novitas — Jurisdiction H
Exact Novitas LCD / ArticlePayer
To Be Confirmed During Domain Validation
Medical-Necessity LogicPayer
To Be Confirmed During Domain Validation
Commercial Payer (high level)Payer
BCBS
Exact BCBS Entity / Plan / ProductPayer
To Be Confirmed During Domain Validation
Test CategoryScope
Respiratory Pathogen Panel (RPP)
First Pilot PanelScope
Keenan's current RPP panel (intended)
Exact RPP Panel / AssayScope
To Be Confirmed During Domain Validation
RPP CPT / HCPCSScope
To Be Confirmed During Domain Validation
RPP AnalytesScope
To Be Confirmed During Domain Validation
Payer-Rule Approval AuthorityGovernance
To Be Confirmed During Domain Validation
Prior Authorization OwnerGovernance
To Be Confirmed During Domain Validation
ABN OwnerGovernance
To Be Confirmed During Domain Validation
Authorized RED Override RoleGovernance
To Be Confirmed During Domain Validation