An Intuitive and Powerful Care Management Software
Part of our integrated Population Health Management solutions, HMS’ Essette Care Management provides unique and proven solutions that combine evidence-based content and cutting edge technology to help you increase efficiencies, meet your specific business requirements and react quickly to changing market and regulatory challenges.
Our advanced, modular architecture—engineered to interface with your existing vital organizational tools including eligibility/claims systems, analytics and portals—puts personalized, data-driven and actionable care plans at your fingertips.
HMS Essette Core Product Offering
Our core products support all care management workflows. All products can be incorporated at launch or added as needed. Essette also allows for interoperability across multiple systems. We specialize in partner integrations to deliver seamless configurations and workflows that streamline your care management ecosystem.
Case Management Seamlessly manage member care plans with individual assessments, specific interventions and involvement of the interdisciplinary care team.
Utilization Management Manage prior authorizations, inpatient admissions and stays and retrospective reviews. Evidence-based guidelines and authorization rules support efficiency and ensure compliance.
Population Management Stratify populations by risk level. Create cohorts based on specific criteria found in Essette or outside data sources. Activate work flow campaigns for the population such as referring to case management or other forms of member engagement.
Appeals and Grievances Manage member, provider, authorization denials, payment issues, and other types of appeals and grievances. Guided step-by-step process using automated tasks with configurable turnaround times and attachments to stay compliant.
Customer Service Connect customer service support with case management activities. Create new issues, provide immediate answers, and efficiently route problems to the appropriate caseworker.
For more information about how you can manage your members’ care more efficiently, request a demo today.