TruCare®
25.1
The TruCare 25.1 release delivers significant advancements in automation, user experience, and compliance, including key updates in AI-powered automation, operational efficiency, clinical management, and regulatory adherence. By addressing pain points like manual workflows, fragmented data systems, and regulatory gaps, the 25.1 update not only improves day-to-day operations but also reinforces the platform’s appeal to prospective clients. Below is a structured breakdown of the release.”
Key Release Themes
We’re pleased to deliver a number of valuable TruCare enhancements to our clients in the 25.1 release. We’ve summarized the enhancements by these key themes:
User Experience & Efficiencies:
Agentic AI-driven prior auth fax processing, major UI/UX enhancements, offline capabilities for TruCare Mobile, and a replatformed,resdesigned Admin Console.
Clinical & Care Management Enhancements:
Introduction of Personalized Medication Lists, Care Plan reassignment functionality, and a split-screen assessment feature for care managers.
Regulatory & Partner Compliance:
Continued alignment with MCG and InterQual certifications, ODAG guidelines, and CMS-0057 mandates.
THEME
User Experience & Efficiencies:
enhancements area
user impact
business impact
enhancements area
Admin Console
Redesign
user impact
- Consolidates & simplifies admin workflow
- Enhances UI/UX with intuitive navigation for a better user experience
- Improves filters & search options
- Eliminates redundant configuration steps
business impact
- Removes vulnerabilities related to using Harman and Flash technology
- Faster load times and improved performance
- Reduces training time and errors
AI-Driven Prior Auth
Fax Intake
user impact
- Al-based OCR extracts key clinical and admin data from faxed documents
- Seamlessly integrates w TruCare CM & UM
- Enables real-time updates to case files with extracted data
business impact
- Eliminates manual fax data entry
- Reduces document handling workload and administrative costs ~40%
- Reduces provider friction by speeding decisioning and reducing unnecessary denials/appeals
Mobile UI/UX &
Offline Access
user impact
- Improves UI/UX for better navigation
- Enables additional features work when low/no web connectivity
business impact
- Increases productivity for field care coordinators and home health professionals
THEME
Clinical & Care Management Enhancements
enhancements area
user impact
business impact
enhancements area
Medication
Management:
Personalization
& Data Entry
user impact
- Enables personalized medication lists
business impact
- Prevents errors
- Improves member satisfaction &
outcomes
Care Plan
Reassignment
user impact
- Enables reassignment of a care plan from one case to another-without having to close and recreate it
business impact
- Ensures care continuity for transitioning members
- Prevents loss of historical data or clinical progress
- Increases documentation accuracy with less manual duplication
Split-Screen
Assessments
user impact
- Introduces a split-screen view within the care assessment workflow
- Enables access to a member’s clinical data while simultaneously documenting the assessment
business impact
- Reduces documentation time
- Enhances documentation speed, accuracy, and completeness
THEME
Compliance
enhancements area
user impact
business impact
enhancements area
CMS-0057 Mandates
user impact
- Adds FHIR standard APIs to TruCare platform
business impact
- Enables compliance with new CMS prior auth interoperability standards (rqd by 2027)
ODAG Phase 2
user impact
- Adds configurable workflows & urgency/extension tracking to AA&G module
business impact
- Enables compliance with ODAG Phase 2
MCG & InterQual
user impact
- MCG: AutoAuth & CareWebQI annual update
- InterQual: Optum/InterQual annual update
business impact
- Enables most current versions of clinical criteria in TruCare