Smart Exchange

Smart ExchangeA full service, hosted EDI management and partner data integration solution

Meet your virtual EDI management team – managing all hardware, software, maintenance and support

  • Achieve CORE certification for HIPAA transactions
  • X12, HL7, XML, EDI and DICOM standards
  • We perform data mapping, testing, validation, real-time transaction monitoring, and reporting

No hassle integrations

  • We install and manage partner integrations on your behalf, saving your valuable IT resources
  • We connect to any internal system and any external partner
  • We develop cross-system workflows to automate cross-functional business processes

Learn how Smart Exchange minimizes the challenges of interoperability »

Smart Connect

Smart ConnectThe most flexible, action-oriented portal solution in the market

Looking to comply with NCQA member connections?

Need to meet state requirements for cost and quality transparency?

Want to help providers close gaps in care?

Advancing member engagement through mobile access and wellness initiatives?

Ready for live customer chat?

With Smart Connect, you choose.

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Smart Record

Smart_RecordA shared health record that supports collaborative care

Customized, dynamic information based on claims data, analytics and collaborative care plans

  • Medications and allergies
  • Conditions, problem lists and progress notes
  • Gaps in care
  • Uploaded lab and test results
  • Remote patient monitoring
  • Provider prescribed health content
  • Mobile-integrated health trackers
  • Innovative permissions put member in control of sensitive data
  • Import and export data in portable CCR/CCD formats

Learn how a Shared Medical Record changes the face of engagement and care collaboration »

Smart Metrix

Smart_MetrixAnalytics for actionable insights into quality, cost, and population health

Smart Metrix reveals opportunities to drive down costs and dig deeper into the data.

Discover root causes, like improper utilization or deviations from best practices, and easily identify outliers and trends with benchmarking and intuitive data visualization. Extend information to providers and drive action through provider portal dashboards and personalized member alerts. »

Smart Care

Smart_CareFull-featured collaborative management across the care continuum

Smart Care promotes a collaborative process for managing chronic and acute health conditions, creating a member-centric care plan that all providers and caregivers can access.

Robust care management capabilities to manage care and utilization

  • Utilization management – including pre-authorization, concurrent review and discharge planning
  • Case and disease management – managing program enrollment, assessments, referrals, care planning and remote monitoring
  • Mobile capability for home and field-based care
  • Automated communication workflows

Customized programs to meet the unique needs of each population, with specially designed programs for Commercial, Medicaid, Medicare and long-term care, including specific employer group requirements. »