Simplifying utilization management
for payers, providers, and patients

SmartUM dramatically reduces the time, cost, and care delays of traditional UM

Improved outcomes

Health Care CFOs

  • More in-network care
  • Lower operating costs
  • Better patient experience

UM Team

  • Greater productivity
  • Fewer manual reviews
  • Faster decisions
  • Fewer faxes

Providers

  • Immediate UM approvals
  • Greater staff efficiency
  • Built-in specialist matching and communication tools

Patients

  • Greater convenience
  • Fewer care delays and less worry
  • Tightly coordinated care

 

Referrals processed

 

Referrals processed

Instant Approvals

SmartUM is a patient-friendly utilization management system for payers and providers. It offers a single, end-to-end solution with everything you need to optimize utilization management. From the provider portal with business rules and decision support, to e-consulting, to UM workflow queuing and letter templates, to reporting and analytics — it’s all here.

SmartUM leverages machine learning, based on your past decisions, to generate immediate responses to provider and patient requests when possible, and minimize administrative time spent on requests requiring manual review. SmartUM is cloud-based, customizable and easy to install, use and maintain.

Real Results

Findings of a 10,000+ physician organization with 1 million+ at-risk members:

 

10,000

Daily referrals

 

15,000

Registered users

 

33,000

Daily communications

 

90+%

Online referral entry rate

 

60+%

Referral instant approval rate

 

300+%

Increase in UM staff productivity

 I can use SmartUM from anywhere in the world to do my review work. It is better than all of the UM systems I have used in the past. – MD Reviewer

 I can use SmartUM from anywhere in the world to do my review work. It is better than all of the UM systems I have used in the past. – MD Reviewer

 I can use SmartUM from anywhere in the world to do my review work. It is better than all of the UM systems I have used in the past. – MD Reviewer