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
Key Features of HELIOSum
Aligned CM and UM Views
Streamlined, Faster Authorizations
Prebuilt UM Pathways
Auto-approvals and Auto-determinations
Configurable Rules Engine
Automated Time Tracking
Evidence-based Criteria Integrations with MCG and Change Healthcare (Interqual®)
Electronic, Automated Prior Authorization Integration with Edifecs
Managed lives through HELIOS
Up to 93%
Increase in care team efficiency
Up to 92%
Care team productivity gains
Total interactions in HELIOS
A Partner Ecosystem Designed For Superior Utilization Management
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.
Benefits of Aligning CM & UM
Streamlined Utilization Reviews, Appeals, and Grievances
Tie Tasks to Triggers to Build Intelligent Workflows
Automate the Triage Process to Identify High-priority Authorizations That Require Fast Turnaround
Automate the Creation of Member Timelines to Speed Intake and Eliminate Errors Associated with Manual Data Entry
Speed Up the Delivery of Services to Drive Higher Plan Satisfaction Ratings
Efficient Data Management, with No Duplication of Effort Across Teams
Reduced Risk of Human Error and Reduced Administrative Burden
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 regulatory timelines are met
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.
Automated Prior Authorization Integration within HELIOS
Although a well-intended tool for utilization management (UM), prior authorization has come under fire for creating red tape, resulting in friction between payers and providers as well as delays in patient care. To solve this, VirtualHealth and Edifecs, Inc., partnered to provide automated prior authorization to HELIOS users, enabling the prior authorization process directly within the platform versus users managing multiple platforms. Learn more about automated prior authorization in HELIOS.
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 payers 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.
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