Provider Enablement
Empower providers with digital solutions to support at-scale engagement, interoperability & compliance.
The Challenge
Administrative burdens strain provider partnerships and clinical outcomes.
Burdened workflows
Manual tasks and data entry pull clinicians away from direct patient care.
Information asymmetry
Providers lack real-time access to complete payer-held clinical and claims data.
Vague incentives
Lack of transparent performance metrics makes value-based care adoption difficult.
Collaboration gaps
Siloed communication tools delay vital referrals and transitional care coordination.
Our Solution
From administrative friction to seamless, data-driven provider collaboration.
Enable providers with a robust portal for self-service, real-time access to submit and monitor requests, view population health intelligence & alerts.
EMR Direct Message, UM Submissions, Quality & Coding Gaps
Agentic AI
Our AI agents accelerate provider enablement.
Care Plan Recommendation Agent
Suggests evidence-based plans of care tailored to patient needs.
Prior Auth Review Agent
Accelerate medical review cycles and reduce administrative costs through intelligent automation.
Document Review Agent
Reduce processing time and rework by automating document validation and completeness checks.
Gap Closure Agent
Improve quality scores and incentive performance through proactive, data-driven gap identification.
Risk Adjustment Coding Agent
Improve quality scores and incentive performance through proactive, data-driven gap identification.
Benefits Review Agent
Enhance member value and reduce unexpected costs through real-time tracking and optimization of insurance benefits.
Data Platform
Our Unified Data Platform is the foundation of our solutions
Unified
data
Harmonize fragmented data into a platform built for healthcare to ensure seamless integration and effortless data management.
Actionable
intelligence
Trigger both human and automated interventions at the right moments to improve quality, reduce administrative burden, and lower medical costs for over 43 million lives.
Event-driven
workflow
Deliver personalized, context-rich workflows by transforming data into real-time insights and eliminating unnecessary administrative tasks through automation.
Case Studies
See how we’ve helped others with provider enablement.
HarmonyCare Health Plan
“From day one, Medecision treated us like partners, not just clients. Their implementation team made onboarding smooth and surprisingly fast, and their support team continues to feel like an extension of our own staff.”
Hawaii Medical Service Association
“I’ve enjoyed working with the Medecision team since 2003. They’re very professional, knowledgeable and energetic. They inspire me to go the extra mile, to work harder. We started years ago with utilization management workflow, administration and reporting. By listening to customer feedback, Medecision has a positive impact on healthcare. Its solutions and services continue to help us achieve our vision of building a healthier, happier Hawaii.”
Health Home Partners of Western NY
“We were able to leverage the technology to help us find our patients, evaluate acuity, prioritize and coordinate actions, even when all other services were down.”
Brand New Day
“We’re always looking for ways to make our technology do more, and Medecision is a big help. We were able to configure our system to process authorizations much more easily for all of our Medicare Advantage members. Our physicians flock to Medecision once they learn their members’ risk scores – including pharmacy and lab data – are there and that they can automate their own authorizations. We all like the idea of having everything coordinated in one system. That’s Medecision.”