Itiliti Health & VirtualHealth Announce New HELIOS® + Itiliti Health SaaS Solution for Healthcare Payers
August 26 2024 - 6:00AM
Business Wire
The new HELIOS® solution integrates Itiliti
Health products to simplify prior authorization, compliance, and
optimizing care and utilization management
With the CMS-0057-F ruling mandating new requirements around
prior authorization and healthcare data exchange APIs, as well as
the more recent emergence of additional state regulations,
VirtualHealth® and Itiliti Health are pleased to announce the
launch of a single-solution platform capable of supporting
healthcare payers’ needs for prior authorization, CMS compliance,
and FHIR® APIs.
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the full release here:
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The new HELIOS + Itiliti Health platform will not only help
healthcare payers meet evolving regulations for prior authorization
and interoperability, but it will provide the industry-leading
HELIOS platform to support cost-effective and streamlined care
management, disease management, population health, and additional
utilization management needs such as concurrent and retrospective
authorizations, appeals, and grievances.
“Itiliti Health has been an incredible partner for
VirtualHealth, and we saw an opportunity to work more closely
together to answer the need for an integrated care management,
utilization management, and prior authorization solution that we
saw in the industry,” said Sue Powers, Chief Growth Officer. “This
new HELIOS + Itiliti Health solution will help payers meet the
evolving federal and state requirements for prior authorization and
interoperability all while helping them to achieve technical
alignment, reduction of operational and tech-stack costs, and
improvement of care delivery and outcomes.”
Potential ROI for HELIOS + Itiliti Health Solution
Customers:
- Millions of dollars saved in administrative costs annually
- More than 93% increase in care team efficiency and productivity
gains
- Near elimination of prior authorization disputes and
unnecessary submissions
- Faster closure of critical care gaps
- 80% faster bi-directional data delivery
Key Features of the HELIOS + Itiliti Health Solution:
- Industry-leading rules engines for enterprise-wide efficiency
and automation
- Out-of-the-box, clinically-vetted workflows for CM and UM
- Best-in-class platform design that’s quick and easy to use
- Automated, concurrent, and retrospective authorizations
- Integrations for fax, EHR, and other provider systems
- Itiliti Health’s best-in-class suite of products including:
- PA Checkpoint™: Is Auth Required? and Policy Transparency
- Policy Management
- Prior Authorization Routing
- Automatic Authorization Rules
- Clinical Decision Assistant
- Configurable assessments, care plans, letters, tasks &
more
- Provider, Member, and Caregiver Portals
- Certified with Change Healthcare’s InterQual and MCG’s clinical
guidelines, providing evidence-based criteria for
authorizations
- HITRUST CSF certified, HIPAA- and HITECH-compliant, NCQA
pre-validated for population health management
- Quick implementation times
- Role-based access control for users
- Advanced reporting, analytics, and insights with intuitive
dashboards and tools for everything from episodes, tasks, risk,
referrals, appeals, grievances, and more
“HELIOS + Itiliti Health delivers a solution that stands at the
forefront of ensuring compliance with critical federal and state
regulations, including CMS 0057-F,” said Michael Lunzer, Founder
and CEO of Itiliti Health.“This new shared solution will enable
healthcare payers to lower costs by eliminating unnecessary manual
processes and proactively identifying members’ needs, simplifying
care and utilization management, and streamlining operations to
drive better health outcomes and high-quality, equitable care.”
Contact VirtualHealth’s Sue Powers
(sue.powers@virtualhealth.com) to learn more about this new
single-solution platform for integrated care management,
utilization management, automated prior authorization, and
FHIR®.
About VirtualHealth
VirtualHealth is dedicated to empowering healthcare
organizations to provide the exceptional value-based care that
members need to change their lives for the better. To do this,
VirtualHealth created the industry-leading medical management
platform HELIOS® to meet the needs of government health plans,
commercial payers, health systems, and specialty providers. Trusted
by some of the largest and most innovative healthcare
organizations, HELIOS supports care and disease management,
population health, utilization management, FHIR data
interoperability, and more. Unrivaled in the industry with 90%
configurability, HELIOS utilizes AI, powerful automations, and
unlimited clinical workflows and integrations to enable faster and
more effective care. Intuitive and easy to use, VirtualHealth’s
solutions help remove provider-payer frictions, lower operational
and administrative costs, and drive productivity and efficiency
gains, all while maintaining compliance. To learn more, visit
www.virtualhealth.com.
About Itiliti Health
Through our innovative solutions, Itiliti Health is at the
forefront of transforming the prior authorization landscape. By
eliminating unnecessary manual processes, implementing automation,
and streamlining operations, we significantly reduce administrative
burdens and operational and clinical costs. Our approach not only
enhances efficiency and creates significant cost savings for payers
but also improves the satisfaction of healthcare providers and
patients alike, making the entire healthcare delivery system more
effective and responsive.
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version on businesswire.com: https://www.businesswire.com/news/home/20240826265979/en/
MEDIA CONTACTS Rob McChane VP of Marketing
rob.mcchane@virtualhealth.com
Cortney Galster Chief Marketing Officer
cgalster@itilitihealth.com