U Utilization Management Verify eligibility, optimize reviews, and streamline appeals and grievances.
C Care Management Enable preventative care, manage medical interventions, and efficiently report on program outcomes.
M Medication Management Perform and bill medical services, ensure medications are safe and effective, and identify ways to improve care.
Q Quality Management Improve outcomes, lower costs, and adhere to standards, such as HEDIS, Stars, and PQA.
Blog Setting Authorizations on FHIR: Improving the Patient and Provider Authorization Experience Through Greater Interoperability Koen Brown February 15, 2023