FAQ
Lab Service Providers FAQ
Q: What is careviso?
A: careviso is a healthcare services company that has developed a proprietary technology solution that provides financial transparency and prior authorization support and comprehensive services that help reduce barriers to access, providing the best laboratory services to your customers. careviso was also formally known as CMT Solutions
Q: What is seeQer
A: seeQer is a secure, online platform that automates benefits eligibility investigation, price transparency and prior authorizations in real-time. It helps labs project revenues earlier, identifies patient payment responsibility, and provides a breakdown of payment responsibility for both patient & payor. seeQer is easy to access and consistently updated, removing administrative burdens from labs.
Q: How is careviso different from other PA vendors?
A: Our incorporated front end workflow streamlines processes and has been built from expertise and experience specific to laboratories. careviso listens to customers, developing customized solutions supported by multiple teams across the organization. We also provide regular data analytics, PA specialists trained in specific lab needs, and two Account Managers are assigned to each lab when contracted with us. To put it simply, careviso customer service is exceptional.
Q: What payors does careviso work with?
A: careviso has the ability to work with payors such as UnitedHeathcare, BCBS, Cigna, Harvard Pilgrim, Carefirst. Over the past 5 years our network has expanded to over 400 payors, with new payors added every month. careviso also works with several laboratory benefit managers (LBMs) such as AIM, Evicore, Availity, Avalon, Tufts, Amerigroup, Centene, and Optum. Your careviso account representative can give you the specific payors that require prior authorizations for diagnostic testing for your patients.
Q: What tests does careviso perform the PA for?
A: careviso has the ability to perform PA for complex genetic testing. We have expertise in Prenatal, Hereditary Cancer, Oncology, Thyroid, and Mental Health. We also perform the prior authorizations for rare genetic testing with our expertly trained specialist team.
Q: How do you handle the flow of information from our laboratory to the careviso platform (seeQer)?
A: We can securely handle the flow of information from your laboratory into our proprietary platform in many different ways. The careviso and Laboratory IT teams will decide on a file transfer method, from the following:
- CSV File to include Box or SFTP
- API
- Input directly from the lab into seeQer
Healthcare Providers FAQ
A: careviso is a healthcare technology company supporting everyone involved in diagnostic testing. We created a proprietary platform, called seeQer, for payors, physicians, and laboratories that improves patient care through streamlined workflows. By automating the impossible we’re solving the most complex problems in the healthcare industry: prior authorizations and financial transparency. careviso was also formally known as CMT Solutions.
Q: What is seeQer?
A: seeQer is a secure, online platform that processes prior authorizations, runs benefits analysis calculations, and is the next step in effectively managing personalize healthcare. It offers visibility to the cases careviso is processing; physicians and staff can see clinical data all in one view and in real-time. seeQer is easy to access and consistently updated, decreasing administrative tasks for the physician office
Q: Is using careviso for prior authorizations HIPAA compliant?
A: Yes, enrolling with careviso for prior authorizations is HIPAA compliant. A Business Associate Agreement (BAA) is required at enrollment to establish a relationship with a HIPAA covered entity (e.g. a clinician’s practice) to ensure the security of the covered entity’s data assets. Prior authorization servicing requires access to Protected Health Information (PHI) and having a BAA with careviso helps ensure security and overall HIPAA compliance. Please see our Security Fact Sheet for more detailed information.
Q: How will enrolling with careviso change our Prior Authorizations process?
A: Enrolling with careviso will take the burden off your office from having to process prior authorizations for diagnostic testing. The enrollment process requires three basic steps for a clinician office: 1) complete the online enrollment form at careviso.com, 2) complete the careviso BAA and Provider Authorization Agreement, and 3) provide the necessary payor credentials to careviso. Once the enrollment process is completed no additional action is needed. Your office will conduct business as usual, focusing on your patient’s care, and prior authorizations will be performed by careviso on your behalf.
Q: What payors does careviso work with?
A: careviso has the ability to work with payors such as UnitedHeathcare, BCBS, Cigna, Harvard Pilgrim, Carefirst. Over the past 5 years our network has expanded to over 400 payors, with new payors added every month. Your careviso account representative can give you the specific payors that require prior authorizations for diagnostic testing for your patients.
Q: What if a payor requires a PA to be directly from a lab?
A: If the lab is contracted with careviso, we will automatically process the PA on the lab’s behalf. careviso also works with several laboratory benefit managers (LBMs) such as AIM, Evicore, Availity, Avalon, Tufts, Amerigroup, Centene, and Optum.
Q: What is UHC Optum and why does it matter?
A: In mid-2021, United Healthcare switched from Beacon LBM to their own internal management system, named Optum. New providers that partner with careviso will need to approve careviso as a 3rd party service provider (TIN) within Optum. This will allow us to process UHC prior authorizations and help patients get access to the genetic testing needed for their care. Please see our UHC Optum Fact Sheet for more detailed information.
Q: What tests does careviso perform the PA for?
A: careviso has the ability to perform PA for complex genetic testing. We have expertise in Prenatal Diagnostics, Oncology, Radiology, Endocrinology, and Mental Health. We also perform the prior authorizations for rare genetic testing with our expertly trained specialist team.
Q: Can I enroll as a practice or will I have to enroll each provider individually?
A: careviso can enroll entire practices and will capture all the providers who order genetic testing under each practice. We will look to capture the NPI of each physician, NP/PA, Genetic counselor and that can be stored under an overall clinic name. If a provider works in multiple different practice group, then each different practice group will need to be enrolled.
Q: How will enrolling in careviso change the ordering process?
A: Enrolling with careviso will not change the workflow of how your order or receive the results of genetic testing from your chosen laboratory. You will continue to send the requisition and samples to the laboratory, and from there, the laboratory will coordinate with careviso for the prior authorization. You can also see the status of the prior authorization by logging into the careviso portal at any point in the prior authorization process.