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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.
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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

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

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Streamlined Utilization Reviews, Appeals, and Grievances

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Tie Tasks to Triggers to Build Intelligent Workflows

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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

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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

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Reduced Risk of Human Error and Reduced Administrative Burden

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

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Ensure regulatory timelines are met

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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.

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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.

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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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