The Utilization Management and Review (UM/UR) process is an area ripe for disruption. Innovation, driven by Artificial Intelligence (AI) and Machine Learning (ML), has brought a new approach to the UM/UR process: the Care Level Score.
Read more in this SmartBrief published White Paper on XSOLIS’ proprietary Care Level Score (CLS) that brings together everything from vital signs and lab results to physician’s notes, medications, and other clinically relevant data in real-time for payers and providers to streamline the case review process. You’ll also learn more on MultiCare Health System, Covenant Health, and Humana’s respective success using the CLS to reduce variability, improve payer provider collaboration, and focus their attention on care optimization over clerical tasks.
SmartBrief, the leading digital media publisher of targeted business news and information by industry, delivers the most relevant industry news to nearly 6 million senior executives, thought leaders and industry professionals.
Frictionless Healthcare is Possible
“In order to collaborate and improve health outcomes for our members and our providers’ patients, we must be collaborative with the data. AI-driven solutions open the door to all the ways we can better work together in partnership as health plans and providers.”
Dr. Rebecca Colon
Regional VP of Health Services, Humana
"The industry is moving to a state where providers and payers have partnered joint status management of our patients and members. That's really what we want to achieve. Not this constant inpatient versus outpatient battle using outdated processes and criteria. Instead, let's all come together and agree on managing the status for the better.”
Samantha Longenbaugh
Senior Network Director of Utilization Management at HonorHealth
PO Box 681789
Franklin, TN 37064
Call us: 855.371.0867
Contact Us