Cadalys CareIQ Utilization Management

Additional Details

Standardize & Operationalize UM Processes Payers and providers need an alternative to current approaches for utilization management that require lengthy, burdensome steps to review and apply clinical guidelines and coverage policies. There is a critical need to break down silos and consolidate content for more consistent and efficient UM processes. Through a flexible, powerful curated content engine that embeds any third party medical coverage policies and evidence-based guidelines into the Salesforce Health Cloud platform, CareIQ for Utilization Management delivers unified workflows to automate clinical decision support across the payer-provider lifecycle. Our purpose-built solution presents review data in a logical and consumable experience that speeds up interpretation and application of UM criteria so clinicians can focus their attention on serving members and patients. - Eliminate swivel chair processes by consolidating clinical review content in a single pane of glass - Enhance payer-provider collaboration to ensure appropriate, timely care and reduce denials - Reduce cost per transaction and improve turnaround times