Simplify Utilization Management

Succeeding in value-based care requires a fresh approach to utilization management (UM). Referrals and authorizations, for example, can play a vital role in effective care management. However, traditional manual processes hinder accurate and efficient utilization management.



Create an efficient, engaging utilization management experience

To optimize UM processes, health systems need to streamline payer-provider communications, enabling bi-directional communication without the time-intensive and error-prone phone calls, faxes and paperwork. Aerial™ iExchange automates traditionally cumbersome, manual UM workflows — like inpatient and outpatient authorizations, referrals and treatment updates. This secure, bi-directional physician portal helps health systems:

  • Expedite workflows to reduce the time and expense associated with manual processes
  • Standardize submission workflows across multiple health plans
  • Speed UM resolutions by automatically sending pended cases to clinical review

By making inpatient and outpatient authorizations, referrals and treatment updates quick and easy, health systems give physicians more time to focus on patient care, resulting in improved patient satisfaction, better care management and streamlined efficiencies.

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Aerial Complex Care Management™ and Aerial Insights™ are NCQA Population Health Management Prevalidated with possible autocredit designation, awarded in standards year 2018. Find out how your organization can benefit.