Our treatment plan review process

We review each treatment plan to determine if it's evidence-based care and complies with your health plan language.

  1. The provider enters the treatment plan into Eviti Connect. The treatment plan appears on your dashboard.
    • If it's evidence-based care and complies with your health plan language, we assign it an Eviti code, which means that we recommend that you authorize the treatment. We skip to step 4.
    • If the treatment plan deviates from evidence-based care or your health plan language, our NantHealth Eviti Medical Office must review it.
  2. Our NantHealth Eviti Medical Office reviews the treatment plan.
    • If we determine that data entry errors caused the deviation, an Eviti nurse updates the treatment plan and the system assigns it an Eviti code. We skip to step 4.
    • If the deviations go beyond data entry errors, our physician requests a peer-to-peer clinical discussion with the treating physician to gather information and to ensure that the treating physician prescribes the appropriate treatment.
  3. Our physician meets with the treating physician. Then, we do one of the following:
    • Assign the treatment plan an Eviti code if we determine that it's appropriate care.
    • Reject the treatment plan by not assigning it an Eviti code if we determine that it's not appropriate care.
    • Require that you review and approve the treatment plan before we assign it an Eviti code. This occurs when we think that there are medically justified deviations from standard of care, but request your approval before assigning it an Eviti code.
    Note: If we request more information or a peer-to-peer clinical discussion, and the treating physician does not respond or cannot meet, we reject the treatment plan. We determine the time to allow a treating physician to respond based on the time that you expect us to complete our treatment plan review.
  4. We email you after we complete the review. The email indicates whether we assigned the treatment plan an Eviti code or if it requires your approval. The treatment plan's status updates on your dashboard and it's ready for you to process.

    You configure the type of notification emails that we send you and who receives them.