HELIOSum® unifies providers, care managers, and UM teams on a single platform where they can access all member information in just two or three clicks. With the intuitive user experience and powerful automations HELIOS® is known for, health plans will revolutionize UM activities to achieve:
- Faster authorizations
- Streamlined utilization reviews, appeals, and grievances
- Efficient data management, with no duplication of effort across teams
- Reduced risk of human error (and less stress for staff!)
- Healthier, happier members
- Higher plan satisfaction ratings
Reimagine How You Deliver UM
Align UM and CM
CM and UM teams can access all the info they need in just a few clicks for a 360° member view.
Create Intelligent Workflows
A configurable rules engine lets you design workflows that fit what you need – without IT support.
Prebuilt UM pathways with industry best practices let you do this from day one.
Keep teams on pace with automated time tracking for authorizations.
Leverage auto-approvals and auto-determinations to speed delivery of services and keep members happy.
Gain Accuracy and Confidence
Add on integrations with guidelines from InterQual and MCG – or design your own with self-service templates.
Automate for Efficiency, Timeliness & Accuracy
Automate much of the workload for your teams, so they can work faster, more accurately, and are free to focus on more complex cases.
HELIOSum® includes data integration and configurable rules so you can:
- 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
- Tie tasks to triggers to build intelligent workflows
- Build a complete, real-time picture of authorizations, grievances, appeals, and events, looping the entire care team in on a single source of truth
And with custom required fields and automated time tracking for authorizations, you can:
- Save providers time and administrative hassle
- Ensure you meet regulatory timelines
A Strong Partner Ecosystem for Superior UM Services
HELIOS® connects you with the industry-leading resources you need to meet your UM goals.
Thanks to a partner ecosystem that includes InterQual and MCG, you can integrate clinical guidelines for enhanced accuracy and compliance. Meanwhile, integrations with brands like Surescripts enable streamlined electronic prior authorizations and appeals.
Positively Impact Member Satisfaction
By connecting teams and data in one platform, health plans can dissolve common barriers that cause poor delivery of UM – and dissatisfied members. (You know what those are: member information scattered across too many systems, slow and error-prone processes, and missed timelines that can ultimately lead to more denials.)
The results? Happier UM staff and providers. Higher member satisfaction. And a simpler path to the future of whole-person care.