Click4Care releases next-generation Utilization Management module for health plan users

Click4Care, a leading provider of care management software for payors, today announced the next-generation Utilization Management (UM) module for its industry leading software platform. By leveraging the UM solution’s extensive configurability, payors and providers can achieve greater levels of productivity while improving clinical, administrative and financial performances.

The UM module is part of Click4Care’s revolutionary care management software platform that allows health plan users to make necessary changes within hours, rather than days or weeks, eliminating reliance on overburdened and costly IT resources. This unequaled, near real-time configurability makes payors responsive to the accelerating need to manage expenses and improve the quality of care, and to do so quickly, accurately and cost effectively.

“Our Utilization Management module is the first in the market to provide a truly end-to-end solution,” said Rob Gillette, CEO of Click4Care. “The turnkey system securely presents all patient data within a single, member-centric view, resulting in streamlined administrative workflows and productivity for payors and providers—as well as superior member care.”

The new UM functionality includes:

• Single view: A single-view window displays the entire member utilization event.
• Automated workflow process: Client-defined rules evaluate care requests automatically to determine approval status.
• System integration: Full integration with claims systems and ability to view clinical criteria from sources such as InterQual and Milliman to validate best practices.

Added Gillette, “Our expanded UM solution allows payors and providers to focus on vulnerable member populations with targeted outreach regarding their current disease state or chronic conditions. These proactive efforts reduce unneeded or preventable healthcare utilization while also improving member health and quality of life.”

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