Ensure to offer healthcare services with the best of quality and employ appropriate procedures with an effective utilization management strategy at your disposal. Get the right digital tool to help your organization through the processes and achieve optimal results. That said, take the step as early as now and move to secure robust utilization management software.
12+ Utilization Management Software
1. Therap Services
4. Trella Health
6. TeleTracking Capacity Management Suite
7. TreeAge Pro Healthcare
8. Conduent Care Management
9. Pharmacy 4.0
12. BlueNote Communicator
What Is Utilization Management Software?
Utilization management software is a modern solution equipped by businesses in the healthcare industry to ensure optimal delivery of healthcare services and procedures. It tracks the activities of physicians to ensure that the services they offer are clinically appropriate and provides digital tools for detecting improper reimbursement. This software integrates the functionalities you need to control in a centralized platform, allowing you to gain better insights into your resource management practices.
Also, it gathers data analytics, measures metrics, and converts data into visual and structured reports. In addition, with this software solution, you can efficiently track and manage costs and streamline the complexities involved in utilization management.
Utilizing this technology in monitoring the quality of the health care services you offer will allow you to map and detect fraudulent behaviors and map the inefficiencies in your daily operations. Also, it has workflow automation capabilities that you can use for managing repetitive and menial tasks productively, saving you more time and minimizing your expenses.
Now that you have decided to go digital, you need to go through another decision-making process of choosing the software for your organization. The more choices, the better. Although, it also does not make it any easier to single out which one can fill in the gaps of your processes and meet your utilization management needs. That said, look into the aspects that matter and study the trends in this software category to gain the necessary knowledge for a more effective filtering process. The elements you should look out for includes their supported digital devices, offered pricing plans, service offerings, their compatibility with the size of your organization, and the following features:
- Workflow management tools
- Electronic health records integration
- Powerful real-time reporting tools
- Cost management features
- Compliance tracking capabilities
- Complaint management functionalities
- Activity tracking capabilities
- Code processing tools
- Custom dashboard
Top 10 Utilization Management Software
With this digital solution, you can use referral management and clinical decision support features. Its developer, Elsevier, has a revenue of 2 billion dollars and has 8,600 people in its team.
When using Noom, you can access its features for patient engagement and mood logging. They have 2.022 employees in their team and have 520.6 million dollars in revenue.
3. Conduent Care Management
Conduent Care Management is a digital solution with disease management tools and care management features. They have 3,479 people in their team and have 353.12 million dollars in generated revenue.
This medical practice management solution offers a patient portal and insurance eligibility verification functionalities. Its company, Greenway Health, has 1,293 employees and 315 million dollars in generated revenue.
5. TeleTracking Capacity Management Suite
TeleTracking is a patient management software with functionalities for optimizing patient monitoring and patient flow management. They have 79.05 million dollars in generated revenue and have 300 employees working for them.
An integrated accounting system and physician management capabilities are features you can use in this financial planning solution. They have generated a revenue of 58.9 million dollars and have employed 406 people.
7. Therap Services
This home care service software has appointment scheduling and compliance tracking tools. They have 47.1 million dollars in revenue and have 325 employees.
Functionalities for in-patient management and facilities management are accessible in this software. They have 139 employees working for them and have a generated revenue of 37.5 million dollars.
9. Trella Health
With this hospice software, you can streamline the activities involved in data visualization and data discovery. They have a generated revenue of 27.5 million dollars and have employed 102 people.
10. TreeAge Pro Healthcare
TreeAge Pro Healthcare is a business intelligence software with digital tools for strategic planning and profitability analysis. They have a revenue of 1.2 million dollars and have six employees.
What are the purposes of utilization management?
One of the purposes of employing utilization management processes is to identify risks and gain a deeper understanding of the data to develop a data-driven risk management strategy. Also, another one of its goals is to avoid misuse of in-patient healthcare services and measure success to constantly pivot business plans and methods to provide effective and advanced care needed by clients.
What are the various categories of utilization management?
There are various types of utilization management, and they vary on the processes and the period you carry out the assessment. The first one is the prospective review which involves performing the review before the treatment to identify the appropriate services and eliminate the unnecessary ones. Concurrent reviews entail monitoring the services delivered and tracking progress during the treatment. Lastly, retrospective reviews refer to assessing the effectiveness and appropriateness of the healthcare procedures after the treatment.
What is the job description of a utilization management specialist?
Utilization management specialists are responsible for analyzing and following healthcare guidelines to ensure that the services are appropriate and are relevant to the specific payor. Also, their duties involve playing an active role in mitigating risks and resolving issues and complaints of payors. Assisting the case manager and the case management staff is also part of the job.
Establish an evidence-based culture in your healthcare organization and gain the capability to access data in real-time to improve organizational effectiveness with the right modern solution at hand. That said, get the best utilization management software for you today to ensure that the services you deliver are compliant and suitable for the payors.
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