Clinical Edge
Authorization Portal
The Authorization Portal, part of Clinical Edge, streamlines preauthorization with automated rules, evidence-based clinical guidance, and secure messaging so decisions happen faster.
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Automated Rules & Configurations
Configure workflows and templates by plan design or line of business. Routine requests auto-authorize, while complex cases flag for review to reduce bottlenecks.
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No-code configuration
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Plan-specific rules
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Flexible templates
Evidence-Based Clinical Guidance
Integrate MCG Cite AutoAuth and InterQual Connect™ so every authorization decision rests on medically sound, evidence-based best practices.
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MCG integration
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Consistent decisions
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Trusted, evidence-based decision support
Secure Direct Messaging
Replace faxes and phone calls with built-in messaging that connects providers and utilization management staff in real time for faster, clearer collaboration.
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Real-time provider messaging
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Direct UM staff communication
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Fax- and phone-free workflows
Clinical Edge Suite
Care
Management
Streamlined workflows and centralized member data help care teams deliver personalized, evidence-based, whole-person care.
Utilization
Management
Clinically sound, workflow-driven tools with intelligent automation optimize the authorization lifecycle and support compliance.
Appeals
and Grievances
An intuitive, end-to-end solution consolidates appeals, supports regulatory compliance, and delivers one-click packet creation.
Authorization
Portal
End-to-end workflows, automated approvals, and real-time provider communications boost operational agility across your plan.
Mobile
Clinician
Secure mobile access lets field staff run assessments, build care plans, capture consent, and start referrals online or offline.
Member
Engagement
A scalable digital platform pairs omnichannel communication with advanced tools to deliver measurable health outcomes.
Population
Health
Real-time analytics and effective stratification identify at-risk populations and help your teams close care gaps faster.
Quality360
NCQA-certified quality management links HEDIS gap identification to care workflows, streamlining closure and reducing manual work.
Business Intelligence
Advanced reporting and dashboards for CMS and NCQA give your teams the insight to drive smarter, data-backed decisions.
Clinical Edge
University
24/7 access to module-based training, so staff can build product expertise on their own schedule, from anywhere.
Effortless Authorization Management
The GuidingCare Authorization Portal cuts phone calls and faxes so preauthorization decisions happen faster.