Enterprise Care Management Platform

The TruCare population health management platform enables you to effectively manage your members, improve outcomes, and lower costs. TruCare will help you get case and utilization processes right — for every program, every member, every time — through collaboration tools for teams, workflows to optimize user productivity, and compliance with regulatory requirements. Download the corporate brochure.

Identify Gaps in Care

Through TruCare, your care and utilization managers can view a 360° longitudinal view of each member, enabling them to identify gaps in care and potential needs, implement interventions, and perform authorizations. TruCare’s comprehensive member dashboard centralizes a member’s information, including demographics, clinical profile, current and past care and utilization management activities, and related communications. With this information, your care teams can facilitate preventive care and ensure members are accessing the services appropriate for their needs, so that healthy members remain healthy and high-acuity members get the special attention they need.

Segment Members by Business

TruCare can segment your member population by lines of business, state, region, program, client, or your own unique definition. This allows for consistent delivery of tailored care and utilization management programs for each population segment, which means that you can apply specific interventions, workflows, rules, and policies according to your segmentation.

Personalize Care Management

TruCare supports the design and deployment of personalized care management programs that meet organizational goals, contractual commitments, and desired outcomes. Using TruCare’s rules-based automation, you can establish guidelines, create logical next-process steps, and ensure members receive the most appropriate care by letting care teams know what they need to do and when they need to do it. Each TruCare user has their own tasks and assignments built into the workflows, and your care teams can collaborate throughout the patient intervention using TruCare’s assessment tools, integrated care plans, and automated follow-up. The TruCare platform is highly extensible, enabling integration with other systems and importing data from multiple sources including the member, provider, claims data, and other sources; this ensures that care team have up-to-date data at their fingertips at every point of contact with the member and their providers, caregivers, and others engaged their care.

Manage Authorizations, Workflows, and More

TruCare supports the life cycle of an authorization, from entry to determination. Through TruCare, you can configure the authorization process to your specific workflows, rules, and policies, optimizing efficiency in authorization intake and processing; prospective, concurrent, and retrospective reviews; discharge planning; clinical guidance; appeals & grievances; compliance monitoring; and more. TruCare can create individual tasks, send tasks to queues, create messages, generate correspondence, and open cases based on your rules.

API-led Connectivity

TruCare allows you to connect data from across your organization’s data ecosystem. Hundreds of APIs enable import and export of data from various sources including XML data feeds, X12‐based 278 messaging, and REST/JSON web services, providing multiple integration points for exchanging data and interoperability. TruCare integrations are virtually limitless.

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