Payers and providers exchange rich clinical data—reducing friction in care and facilitating a better experience for members.
Administration & Operations
Streamline administrative tasks and operational workflows with powerful tools for scheduling, billing, resource management, and reporting, improving efficiency and reducing overhead costs for payer organizations.
Administration & Operations
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Medical Management
Optimize member care with integrated tools for utilization management, facilitating appeals and grievances, enrolling members in case management programs, viewing members' social drivers of health, and connecting members to community resources.
Medical Management
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Provider Collaboration
Enhance teamwork and efficiency with tools that facilitate secure data exchange and communication, task automation, and shared workflows among providers and payers, ensuring timely and coordinated member care.
Provider Collaboration
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Population Health
Drive proactive health management with comprehensive tools for risk stratification, care coordination, and performance measurement, helping payer organizations achieve better outcomes for their member populations.
Population Health
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CRM for Healthcare
Understand your callers and consumers, proactively address their needs, and learn from your interactions to provide a warm, tailored, and meaningful digital experience.
CRM for Healthcare
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Portals
Provide online access to members, provider partners, and employers with a brandable integrated portal for communicating with and interacting with the health plan.
Portals
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Healthcare Intelligence
Unlock actionable insights with advanced analytics tools that aggregate and analyze healthcare data, supporting informed decision-making, research, and quality improvement initiatives for payer organizations.
Healthcare Intelligence
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Prior Authorization
Simplify the prior authorization process with integrated tools that automate requests, track approvals, and ensure compliance, reducing administrative burden and improving member access to care.
Prior Authorization
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Real-Time Prescription Benefits
Provide members and providers with instant access to prescription benefit information, including coverage details, costs, and alternative options, ensuring informed decision-making and cost-effective medication management.
Real-Time Prescription Benefits
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KLAS 2024 Points of Light Awards
Strategic partnerships between payer and provider organizations and their HIT vendors are becoming a cornerstone of transformative improvements to healthcare processes and outcomes. KLAS’ annual K2 Collaborative Points of Light awards celebrate such partnerships’ successes—or “points of light”—in reducing cost and inefficiencies and improving the patient, provider, and payer experience.
Providers and Health Plans Connect to Fast Track Prior Authorization, Claims, and Quality Reporting
Using Payer Platform, Mayo Clinic and a statewide health plan reduced ADR denials by up to 75%; Baptist Health and Humana automatically exchanged 24,000 charts in one year; and Ochsner Health and Humana completed 53% of prior authorizations instantly.
Providers and Payers Team Up to Increase Price Transparency for Patients
Kelsey-Seybold Clinic got a head start on the advanced explanation of benefits requirements of the No Surprises Act by adjudicating estimates for the health plans it manages, resulting in a 94% accuracy rate.
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