CareIQ for Salesforce: Utilization Management and Care Management

Additional Details

CareIQ for Salesforce gives health payers and providers new ways to address technology challenges impacting their ability to deliver access to timely, quality care for members and patients by consolidating and unifying previously siloed content sources into a single pane of glass. Putting critical clinical and operational content at the fingertips of clinicians and staff eliminates much of the manual, time-consuming swivel-chair processes traditionally required to ensure medical necessity and authorize care for members and patients. Unified care planning: embedded support of National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAQ), Centers for Medicare & Medicaid Services (CMS), and Healthcare Effectiveness Data and Information Set (HEDIS) standards to streamline and automate assessments for interdisciplinary care teams. Streamlined utilization management: Clinicians receive intelligent recommendations that can automate the process of researching and applying the correct policies and guidelines based on attributes like line of business, geography, authorization request type and procedure/diagnosis codes