Who We Serve
- - - Discover HELIOS for Advanced CM, UM & Interoperability
      
      The only 90% configurable platform that supports CM, UM, and FHIR^® interoperability, discover how HELIOS can help you meet evolving requirements for prior authorization, and interoperability, all while improving your overall CM, UM, and data exchange initiatives and outcomes.
Solutions
- - - Discover HELIOS for Advanced CM, UM & Interoperability
      
      The only 90% configurable platform that supports CM, UM, and FHIR^® interoperability, discover how HELIOS can help you meet evolving requirements for prior authorization, and interoperability, all while improving your overall CM, UM, and data exchange initiatives and outcomes.
Our Approach
- - - Discover HELIOS for Advanced CM, UM & Interoperability
      
      The only 90% configurable platform that supports CM, UM, and FHIR^® interoperability, discover how HELIOS can help you meet evolving requirements for prior authorization, and interoperability, all while improving your overall CM, UM, and data exchange initiatives and outcomes.
Resources
- - - Discover HELIOS for Advanced CM, UM & Interoperability
      
      The only 90% configurable platform that supports CM, UM, and FHIR^® interoperability, discover how HELIOS can help you meet evolving requirements for prior authorization, and interoperability, all while improving your overall CM, UM, and data exchange initiatives and outcomes.

UTILIZATION MANAGEMENT SOLUTION

Utilization management software that drives faster authorizations, streamlines processes, and aligns with care management in a single, easy-to-use platform.

Aligning UM & CM in a Single Solution

HELIOSum unifies providers, care managers, and utilization management (UM) teams on a single platform to revolutionize UM activities. With the intuitive user experience and powerful automations HELIOS^® is known for, health plans can access all member information in just two or three clicks to align UM and CM, streamline authorizations, drive efficiencies, and gain accuracy and confidence.

ClinicalCarePathways illustration

Key Features of HELIOSum

12+ Million

Managed lives through HELIOS

Up to 93%

Increase in care team efficiency

Up to 92%

Care team productivity gains

37 Million

Total interactions in HELIOS

VH_Shot

A Partner Ecosystem Designed For Superior Utilization Management

HELIOS connects you with the industry-leading resources that you need to meet your UM goals.

Thanks to a partner ecosystem that includes Edifecs, Change Healthcare (InterQual) and MCG among others, you can integrate clinical guidelines for enhanced accuracy and compliance, automate prior authorizations, and more. Other integrations also enable streamlined electronic prior authorizations and appeals.

Ask us about our complete list of UM Partners >

Benefits of Aligning CM & UM

faster authorizations

Faster Authorizations

streamlined utilization management icon

Streamlined Utilization Reviews, Appeals, and Grievances

tasks to triggers icon

Tie Tasks to Triggers to Build Intelligent Workflows

automate triage icon

Automate the Triage Process to Identify High-priority Authorizations That Require Fast Turnaround

automate creation of timelines icon

Automate the Creation of Member Timelines to Speed Intake and Eliminate Errors Associated with Manual Data Entry

speed delivery icon

Speed Up the Delivery of Services to Drive Higher Plan Satisfaction Ratings

efficient data management icon

Efficient Data Management, with No Duplication of Effort Across Teams

reduced risk of error icon

Reduced Risk of Human Error and Reduced Administrative Burden

real time picture icon

Build a complete, real-time picture of authorizations, grievances, appeals, and events, looping the entire care team in on a single source of truth

ensure timelines are met icon

Ensure regulatory timelines are met

SHOW MORE

Watch a Quick Demo of HELIOSum

Ensure health plan members get the clinically-indicated services, prescriptions, or products they need, when they need them.

See how HELIOSum could help you achieve faster authorizations; streamline reviews, appeals, and grievances; reduce risk and staff workload, and more.

HELIOS illustration

Discover-more-about-HELIOShub-blog

PDF GUIDE

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.

VIEW NOW

The HELIOS Product Family

Explore the complete HELIOS product family including our esteemed care management, utilization management, data interoperability, telehealth, and mobile solutions.

Our best-in-class intuitive platform solution for care management, disease management, population health management, and more.

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

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 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.

Connect with Us

We understand that choosing medical management technologies can be a big decision. That is why we provide a highly consultative and refined approach that allows you to learn, ask questions, and identify if our HELIOS solutions are a good fit. Click below to set up a time to chat with our team or to get more information about any of our HELIOS products.

Explore More

Get the latest insights and news from VirtualHealth including product updates and upcoming webinars or white papers.

FOC Episode 10 – April

BLOG

Future of Care - Episode 10: The Connected Care Ecosystem in 2024

BLOG

Using AI and UM Workflows to Automate Prior Authorization, Determinations & More

ImproveDataAnalyticsHELIOS_notext

BLOG

6 Ways Healthcare Payers and Plans Can Improve Their Data & Analytics Initiatives

No Record Found