Delegated Specialty Utilization Management Organization
Cohere Health, EviCore by Evernorth, Carelon Medical Benefits Management, Evolent and others.
Review the category →Market structure
Operating-model categories
The taxonomy classifies each organization by the workflow or information model where it begins. Categories simplify a complex market without implying that every organization inside one category has equal scope, depth, or fit.
Payer Utilization Management Workflow Platform
HealthEdge GuidingCare, ZeOmega Jiva, VirtualHealth HELIOSum, Itiliti Health.
Review the category →Clinical Criteria And Decision Support
MCG Health, InterQual by Optum.
Review the category →Provider-Side Authorization And Patient-Access Automation
Waystar, Experian Health, Infinx Healthcare, R1 and others.
Review the category →Payer-Provider Authorization Network And Clearinghouse
Availity, Rhyme.
Review the category →Pharmacy Electronic Prior Authorization And Medication-Access Network
CoverMyMeds, Surescripts, DrFirst, CenterX.
Review the category →FHIR Interoperability And Compliance Infrastructure
Edifecs, Onyx Health, Smile Digital Health, Redox.
Review the category →Utilization Review Decision Intelligence
Anterior, Latitude Health, Case Health AI.
Review the category →Concurrent Review And Medical-Necessity Collaboration
Xsolis.
Review the category →