Real-time access to complete member data accelerates prior authorization submission, review and approval, while streamlining claims adjudication. A single source of truth eliminates manual data gathering, ensuring CMS 0057F API compliance for Prior Authorization while reducing delays.

Comprehensive member data allows healthcare stakeholders to segment populations by health conditions, demographics, or utilization patterns. This enables targeted programs for high-risk groups, addressing social determinants of health and enhancing preventive care initiatives.

A 360° view enables healthcare stakeholders to use historical and real-time data for accurate risk assessments and predictive analytics. This helps identify high-risk members and create proactive care plans to mitigate future complications.

With a complete view of member history, claims, and clinical data, care teams can personalize interventions, manage chronic conditions, and coordinate care across the care continuum, improving continuity and reducing unnecessary procedures.