Dashboard treatment plan tabs

The following table describes the tabs that may appear on your dashboard, and the treatment plans that each tab displays.

Note: Health plans configure the dashboard based on their business needs. The information and features in this guide may not exactly match what you see in your system.
This tab... Displays...
Appeals Treatment plans that you denied and the provider appealed.
Note: The workflow to appeal a denied treatment plan is an add-on feature that is available at an extra cost. Contact your NantHealth Eviti account manager to implement this workflow.
Approval Req'd Treatment plans that deviate from evidence-based care or your health plan language, but we think are appropriate care. We request your approval before assigning them an Eviti code.

Additionally, most clinical trials appear on this tab so that you can review and approve your payment responsibilities.
Eviti Code Treatment plans that we approved and assigned an Eviti code, which means they follow evidence-based guidelines and your health plan language, and represent appropriate care for the patient.
Code Denials Treatment plans for which we did not assign an Eviti code. This may occur for the following reasons:
  • The treatment plan does not meet evidence-based guidelines or your health plan language.
  • The provider did not supply sufficient medical records for a treatment plan that didn't receive an automatic Eviti code.
  • We requested a peer-to-peer clinical discussion with the prescribing physician, but it did not occur.
Pending Eviti Review New treatment plans that the Eviti Medical Office is currently reviewing. Please check back later to view our recommendation. The time it takes for us to review each treatment plan varies by payer and treatment plan review priority.

This tab includes new treatment plans only. It does not include appealed or reconsidered treatment plans, or treatment plans to which a user added supportive drugs.
Partial Approvals Treatment plans that we partially approved. Some of the drugs received an Eviti code, and some did not.
All Records All treatment plans except those that require your approval.