Member-centered payer care management
Drive cost-effective, coordinated care in the digital age of healthcare with an integrated, dynamic solution. Engage your providers and members to enhance care management and save on medical and administrative costs. Our solution unlocks value for health plans, from care management to referrals to prior authorization.
Improve care management outcomes
Take your providers’ care management initiatives to the next level. Engage providers and members to collaborate on shared care objectives.
Automate and Simplify Care Coordination
Capture and aggregate data to identify and manage health conditions. Enable payers to manage configurable authorizations and referrals, electronically exchanging data.
Identification and Risk Stratification
Identify and prioritize members with elevated risk or chronic conditions to drive personalized interventions.
Unlock SDoH Insights
Look beyond clinical data to proactively identify and address social determinants of health (SDoH) to improve downstream health outcomes.
Streamline prior authorization
Improve the provider experience with a point-of-care prior authorization interface paired with streamlined processes and review systems.
Unlock Automated Responses
Leverage dynamic analytics and clinical data to send automated responses, allowing members to book appointments and stay engaged through texts, reminders, and voice updates.
Customize service forms and provide practical worklists and dashboard views to streamline communication between providers and utilization management teams. Access intelligent insights to make decisions about care delivery.
Closed Referral Loops
Follow up on all referrals to reduce leakages, improve adherence to pre-visit protocols, and reduce no-shows. Share specialist visit summaries with the referring provider to help close referral loops.
Reduce healthcare costs
Reduce administrative costs and achieve your clinical and financial goals with effective payer-provider collaboration.
Optimized Provider Contracts
Streamline contracting with improved payment accuracy.
Make Data-Driven Decisions
Avoid errors or adverse events and help caregivers be more efficient with data-based insights.
Refine Risk Stratification
Use advanced analytics to identify and target high-risk patients.
Use Code Editing Technology
Quickly process and ensure that claims codes comply with a payer’s requirements.
Streamline care navigation to improve member engagement
Effective care management lets members take control of their own healthcare by helping them find cost-effective, in-network options for care—and helps providers and members work together.
Effective Member and Provider Engagement
Empower members with educational content and other resources specific to their needs. Keep providers informed about care strategies.
Clinical Risk and Care Insights
Evaluate clinical risks and member needs through assessments and surveys. Leverage longitudinal care insights on all encounters and procedures.