U.S. Healthcare Payer Care Management Workflow Applications Reviews and Ratings

What are U.S. Healthcare Payer Care Management Workflow Applications?

The primary payer care management workflow applications user is the payer-employed care manager (under titles such as nurse, care coordinator, health coach or health advocate). This person does the work of utilization management (UM), case management (CM), disease management (DM) or wellness program support. This work includes comparing requested services against standards of medical necessity, interacting with providers and their administrative staff, completing assessments with members during telephone engagements, establishing and documenting progress on care plans, and motivating member behavior change. The role of the care manager, however, is diversifying in today’s market. Care managers work in support of many different business and operating models, deploying widely differing expertise across many different communication channels.

Products In U.S. Healthcare Payer Care Management Workflow Applications Market

"Beware over customization pitfalls "

Increased overall UM capabilities & process functionalites. superior software to previous program. customization options have proved to be ultimately advantageous although at times it seems we may have over-customized as a lot of glitches pop up after update launches. feels like we fix one thing & it breaks something else.

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"i feel it was great now "

I appreciated the ease of use of the system. its a great experience working learning , health care industry has many more points to view and and learn many more things . I am enjoying with the vendor

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"VirtualHealth "

VirtualHealth provides an incredible, intuitive and sophisticated product in their HELIOS platform. The VirtualHealth team is easy to work with and demostrates a commitment to excellence and client satisfaction.

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"Implementation was easy, should evaluate integration options with current eco system"

TranZform binds well with Facets core. Implementation was easy and risk free.

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"Data Integrity and Consistency is Key for Implementing Acuity"

Acuity allows a decent level of customization and provides a level of structure that streamlines many business processes for healthcare pre-authorization and referral processes. There are times when system architecture creates a limitation for something the company wants or needs, but TCS is helpful in trying to provide acceptable workarounds.

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"Powerful tools for typical use cases, with some difficulty in enhancement capabilities"

This is a very powerful system, but extremely hard to master or extend. Unless you are an absolutely huge customer, we found it difficult for our requests on enhancement to be taken quickly or with much weight and have waited years to see our enhancements considered. If you have typical requirements this could be an immensely helpful and even competitively advantageous system, but you must carefully review your requirements before engaging DST

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"Implementation has been difficult, we are promised that good results will happen"

They assigned a junior team to implement this for us.

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