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
Communications sent
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