TruCare®

Enterprise Care Management Platform

TruCare is an enterprise population health management platform that enables you to effectively manage your members, to improve outcomes and lower costs. TruCare provides a 360-degree longitudinal view for each member, enables teams to collaborate, improves productivity, and ensures compliance with regulatory obligation. Download the corporate brochure.

Identify the Right Care, at the Right Place, at the Right Time

Utilization and care managers access a 360-degree longitudinal view of each member, enabling them to identify gaps in care and potential need, implement interventions, and perform prior authorization using the comprehensive member dashboard that provides insight to current and historical information. This information includes demographics, communications activities, care management activities and member clinical profile. With this information, care teams can facilitate preventative care and ensure members are accessing appropriate services, so healthy members remain healthy and high-acuity members get the special attention they need.

Line-of-Business Management

In TruCare, you can segment your member population to consistently deliver tailored care management and utilization management programs to each population. These populations can be set up in many ways including lines of business, state, region, program, client, or your own unique definition. Further, you can target specific interventions for each population and automatically execute workflows, rules, and policies according to your segmentation.

Care Management

Care management organizations can design and deploy personalized care management programs that meet their organizations’ goals, contractual commitments, and achieve desired program outcomes. Using rules-based automation, your plan can establish guidelines and create logical next process steps to ensure care teams know what they need to do, and when they need to do it to ensure members receive the most appropriate care. Care Management teams collaborate throughout the care management continuum, effectively using assessment tools, integrated care plans, and automated follow-up while each user has their own tasks and assignments built into the workflow. 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 care management team members have up-to-date data at their fingertips at every point of contact with the member, his/her providers, caregivers and others engaged in the member’s care.

Utilization Management

In TruCare, users can efficiently manage utilization including appeals and grievances, authorizations, procedure requests, concurrent reviews ,discharge planning, care coordination, and more. TruCare is configured to your specific workflows to optimize efficiency and reflect your policies for each line of business. Your plan can enable rules-based automation, establish guidelines and create logical next process steps to ensure care teams know what they need to do, and when they need to do it to ensure members receive the most appropriate care. TruCare can create individual tasks, send tasks to queues, create messages, generate correspondence and open cases based on your rules.

Interoperability

All actions accomplished within the TruCare User Interface can also be accomplished through a web service. TruCare has hundreds of APIs to import and export data and was designed to consume and integrate health plan data from various sources including XML data feeds, X12‐based 278 messaging, and REST/JSON webs services. Casenet is also a founding member of the Da Vinci Project and is collaborating with other participating organizations to develop a FHIR-based API. TruCare integrations are unlimited and many other native features provide multiple integration points for exchanging data and interoperating with external systems.

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