Delivering Healthcare Solutions Designed for Value-Based Care

What to Know About CMS-0057-F: Quick Facts & Next Steps

Here’s what you need to know about the finalized CMS interoperability and prior authorization rule CMS-0057-F, and the three big steps to take in 2024 because of it.

Harnessing AI in HELIOS

Learn about how HELIOS is harnessing AI for predictive analytics, automated decisioning and prior authorization, and more.

Discover HELIOS' Interoperability Product

Discover the power of FHIR® compatibility and faster data interoperability. Download this quick information sheet to learn more about the key features and benefits of HELIOShub.

Our Mission is Care

We’re not trying to reinvent healthcare. Our mission is to provide the leading technology you need for exceptional care, disease, and utilization management, and healthcare interoperability. Our advanced workflows and automations, paired with unmatched 90% configurability, enable your teams to focus on what matters – your members.

We believe that medical management technology should be intuitive, effective, and easy to use. With our member-centric platform HELIOS® , you can offer each individual you serve the most proactive and personalized level of care possible.


A Single Solution for CM, UM & Interoperability

Prior Auth. FHIR APIs. Configurable Workflows. Industry-Leading CM/UM Platform.

Meet CMS-0057-F requirements now with our next-generation HELIOS platform. The only care and utilization management platform with 90% configurability out-of-the-box, HELIOS gives you a single solution to advance medical management. Leverage advanced AI-driven prior authorization automation and decisioning, configurable workflows, and plug-and-play FHIR interoperability. 

Proven Results

12+ Million

Managed lives through HELIOS

Up to 93%

Ability to improve care team efficiency

Up to 92%

Care team productivity gains

HELIOS Product Family

Everything you need in a single, intuitive, highly configurable solution. HELIOS has been leading the industry in user experience and cloud-based healthcare management for over a decade.

Explore the breadth of fully integrated HELIOS product offerings, including our market-leading care management, utilization management, data interoperability, telehealth, engagement, and mobile solutions

Our best-in-class, highly-configurable intuitive platform solution for healthcare payors needing to support care management, disease management, population health management, and more.

Advanced utilization management solution that streamlines utilization reviews, appeals, and grievances, offers automated prior authorization capabilities, improves data accuracy and confidence, and drives cost-saving efficiencies.

Our built-in telehealth tool, HELIOSvisit enables fully secure and HIPAA-compliant videoconferencing, audio calls, instant messaging, and two-way file exchange with members from a computer, smartphone, or tablet without any additional software downloads.

HELIOStext enables convenient, secure outbound text message communications to individual members directly from HELIOS or HELIOSgo, with pre-configured and customizable message templates.

The mobile app version of HELIOS platform, HELIOSgo is uniquely designed for easier in-the-field and on-the-go care management and coordination, and specifically tailored for complex care management, LTSS, home health and behavioral health needs.

With HELIOShub payors can quickly and easily make all of their data FHIR® compatible, while also simplifying their tech stack, reducing costs, and improving team efficiency and data accuracy.


Discover the Power of HELIOS Solutions

Download our quick product guide to learn about our family of HELIOS healthcare solutions. HELIOS is 90% configurable and supports care management, disease management, care coordination, LTSS, behavioral health, utilization management, and data interoperability – all within one single platform.

What Our Customers Say

At ICP, we have a very specific vision for continuing to elevate the high-quality support we offer both our members and our care teams, and VirtualHealth has been instrumental in powering new efficiencies and data-driven workflows to achieve this vision. From day one of our implementation, the experts at VirtualHealth have demonstrated a keen understanding for the needs of our market and we are already seeing tremendous results from the partnership.

Karen Vanaskie, DNP, MSN, RN, Chief Clinical Officer

We’re excited to bring VirtualHealth’s HELIOS platform to PacificSource. As our organization continues to grow, HELIOS’ ability to scale and match the proactive care we provide our members is vital to the ongoing health of the communities we serve.

Martin Martinez, Vice President of IT-Enterprise Systems

Connect with Us

We understand that choosing medical management technologies can be a significant decision. That is why we provide a highly consultative and refined approach that allows you to explore all of the capabilities of HELIOS and understand how we both implement and support clients.

Chat with our team for more information about any of our HELIOS products.