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

UM Team

Providers

Patients

  • More in-network care
  • Lower operating costs
  • Better patient experience
  • Greater productivity
  • Fewer manual reviews
  • Faster decisions
  • Fewer faxes
  • Immediate UM approvals
  • Greater staff efficiency
  • Built-in specialist matching
    and communication tools
  • Greater convenience
  • Fewer care delays and
    less worry
  • Tightly coordinated care

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 to 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 the UM systems I have used in the past.

— MD Reviewer

SmartUM is far easier to use than other payers' referral systems.

— SmartUM clinical user

We offer SmartUM to capitated providers to help them with their care coordination.

— UM Director