Medical Management Designed for Highly Complex Populations

Care Management

Intelligent, Collaborative Workflows for Optimal, Timely Interventions.

Care Coordination

Caseload management algorithms, customizable assessments and care plans, real-time risk stratification, and care team collaboration tools seamlessly unite in a single, centralized record.

The platform couples a patient-centered design with a robust library of integrated programs for physical health, behavioral health, long-term services and supports, home health, and transition programs.

Case Management

Create a tailored solution for members using comprehensive and automated data gathering, that considers physical, behavioral, and social determinants of health.

An intuitive interface allows the care team to easily determine the proper steps to increase care plan adherence and create a better quality of life for members.

Clinical Workflows

Automated workflows with custom rules and evidence-based clinical content enable care teams to identify the most optimal and timely next action.

Accurate data and actions at the care team’s fingertips improve efficiency and productivity.

Utilization management

Configurable Rules-Based Workflow from Request to Determination.

Authorization Requests

A complete workflow for both episodic and chronic service authorization requests, from inquiry to review and disposition.

The platform provides care teams with powerful tools to make timely and accurate utilization management decisions.

Auto-Approval Rules

An embedded auto-approval engine and an extensive library of customizable clinical content leads to better care.

The proprietary engine enables both auto-approvals and auto-pends, distinguishes between authorization types, supports rule hierarchies, and provides a uniquely intuitive interface.

Process Management

VirtualHealth creates a utilization management process designed to minimize inefficiencies, reduce costs, and bolster care standards.

Automation of the entire process is provided seamlessly for the care team and patient.

Disease Management

Improve Quality of Care for High-Risk Patients.

Collaborative Care Plan

The care plan contains standard elements, such as health needs, care goals, activities and interventions, barriers to progress, and progress status and automates the clinical decision making associated with evidence-based best practices.

The care plan also incorporates support for both physical and electronic signatures, ensuring that all required sign-offs are captured on a timely basis.

Timely Interventions

The platform incorporates a range of tools and workflows to support appropriate and timely interventions.

A collaborative and interactive workspace enables social services, medication management strategies, and provides education for the patient.

These ensure that the care coordinator can focus on ways to assist the patient and caregiver in the disease management process.

Comprehensive Toolkit

VirtualHealth incorporates a breadth of tools to support disease management, including health risk assessments, clinical content and workflows, call center forms, educational outreach, connected devices, and self-reporting.

The platform provides an extensive library of assessments and clinical content based on evidence-based guidelines that is customizable based on organizational needs.


Setting New Standards