PIVIT

PIVIT is short for Patient Information Virtual Integration Tool. Aptly named, PIVIT is the central point for all data related to benefits, eligibility, medical claims, pharmacy claims, biometrics, provider-submitted referrals, pre-certifications, and utilization review information, as well as all information discovered during plan participant calls. All relevant patient information is housed in this single platform and most of it is updated on the spot.

Here’s what really makes the system powerful (and smart): PIVIT enables our Care Coordinators to act on your plan participants' behalf in real-time. Put another way, Care Coordinators can help plan participants understand what they need to know before they make decisions that could lead to unproductive, unnecessary and costly care. What’s more, it allows Care Coordinators to alert participants who have a chronic or costly condition and then route that person — immediately— to Case Management, Disease Management and wellness resources.

That means that the diabetic patient who calls in with a claims question can be immediately engaged and encouraged to speak to the Disease Management nurse who’s been trying to reach him. Or, the busy healthcare worker who calls in to see if her doctor is in-network can be reminded to take advantage of her plan’s benefit that pays for an annual physical.

These immediate interventions help to keep costs down by helping to keep minor problems from snowballing out of control.