Sharing and Exchange
Solutions for fee-for-service to fee-for-value
Aerial™ supports bi-directional, multiplatform communication, connecting everyone in the patient’s care circle. The solution serves as a foundation for an evidence-based approach to optimizing care, while eliminating excessive treatment and expense.
For example, automatic referral management and authorization tools are tied to best-practice workflows. And at the heart of Aerial Utilization Management is the ability to apply consistent business rules to determine automatically whether a request for service is approved or pending.
Aerial Utilization Management includes:
- Portal and CRM for HIPAA-compliant provider-patient interactions and existing workflow integration with EMRs.
- A Utilization Management Platform that obtained URAC’s Health Utilization Management in 2011 and remains accredited to date.
- Auto-approval rules to create conditions for when a request can be approved without passing through a clinician’s review.
- Use of request questionnaires to ask additional questions when a request meets the specified criteria. Based on the responses, the request may be auto-approved.
- Auto workflow rules designed to refer those meeting pre-configured conditions to a specific care management or disease management nurse or a department.
- Regulatory management through the use of the Review Type field to auto-calculate due dates or manage turnaround times, including concurrent review, through the Tasks features.
- Correspondence management to meet notification standards.
- Streamlined workflows and configurations, rooted in evidence-based medicine, to address overuse and underuse of healthcare services resulting in potential risks that can greatly outweigh any potential benefits.
- Utilization Management Initial Review with:
- Concurrent Review and Discharge Verification
- Quality/Peer Performance Review
- Program Screening and Enrollment
- Ongoing Program Management to Closure
- Medical Director and Auditor Workflow Paths
- Easy creation, updating and processing of utilization management transactions—resulting in fewer phone calls, fewer errors and significant time savings.