- Frank LaSota, Chief Technology Officer
Studies show that AI-driven automation can reduce administrative costs by up to 25 percent while boosting revenue by as much as 12 percent. For health plans facing budget pressures, staffing constraints, and evolving regulatory demands, those results point to a clear opportunity to modernize critical processes.
Health plans are under constant pressure to optimize operations, maintain compliance, and deliver measurable results across increasingly complex member populations. At Zyter|TruCare, we know that care teams need more than surface-level upgrades. They need purposeful technology improvements that directly support their goals, from reducing intake delays to enabling field teams in disconnected settings.
The TruCare 25.1 release delivers exactly that. Built around core needs identified by our client community, this update introduces enhancements that improve speed, scalability, and oversight across critical workflows. Whether you are leading a utilization management team, coordinating community care, or preparing for audits, TruCare 25.1 offers practical improvements that make your job easier and your impact stronger.
Turning Manual Intake into Intelligent Action
Prior authorization intake often creates bottlenecks. Paper faxes and scanned documents require teams to manually read, route, and input key data. This leads to slow turnaround times, inconsistent decisions, and rising labor costs.
TruCare 25.1 embeds AI into intake workflows by using optical character recognition to extract structured data and applying configurable business rules to classify and route requests automatically. Tasks are then generated and assigned to the appropriate team queue without manual intervention.
This shift transforms intake from a reactive task into an intelligence-driven process. Clients gain faster turnaround times, more consistent processing, and higher documentation quality—all contributing to lower administrative expenses and stronger audit performance.
Empowering Mobile Teams in Disconnected Environments
Home and community-based care depends on flexibility, yet connectivity gaps can disrupt workflows and compromise documentation. TruCare 25.1 extends the mobile platform with full offline support. Care teams can complete assessments, review dashboards, and capture visit notes without an internet connection. Once reconnected, all data synchronizes automatically with the central system. This capability ensures uninterrupted care delivery and reliable data capture, especially in rural and underserved areas.
Compliance and Audit Readiness Built into Core Workflows
Regulatory expectations around appeals, grievances, and electronic authorizations continue to evolve. TruCare 25.1 adds built-in tools to meet these requirements without custom development or workaround solutions. Key updates include:
- Structured ODAG and CDAG fields for standardized appeals and grievance tracking
- Split-screen assessment views for simultaneous review and documentation
- FHIR-based APIs to align with electronic prior authorization mandates
- Configurable data retention settings to meet internal and regulatory policies
- SQL Server 2022 compatibility to improve performance and scalability (TruCare 25.1 has also been validated on Windows 11, ensuring compatibility with the latest enterprise operating environments)
TruCare 25.1 also incorporates the latest MCG and InterQual clinical content to ensure care decisions are aligned with the most current evidence-based guidelines.
Embedding these capabilities into everyday workflows reduces manual effort, standardizes reporting, and positions clients for successful audits.
Clinical and Operational Enhancements That Drive Results
In addition to backend and compliance updates, TruCare 25.1 includes clinical workflow improvements that support both care quality and team efficiency.
Care teams can also reassign care plans without closing and recreating them, preserving historical context and minimizing disruption during member transitions. These enhancements help maintain care continuity, improve documentation accuracy, and save valuable time.
Added Configurability for Operational Flexibility
For organizations seeking more precise control, TruCare 25.1 offers optional enhancements:
- Business Hierarchy Profile dropdowns to customize user access
- Plan and program groupings to streamline member management
- System prompts to guide task completion and reduce errors
These features can be enabled as needed, allowing teams to tailor TruCare to their operational structure.
A Smarter, More Sustainable Approach to Care Management
With increasing reimbursement pressure and limited staff resources, health plans cannot afford inefficient processes. TruCare 25.1 reflects our commitment to capability-driven innovation that delivers real ROI. By embedding AI where it matters most, enabling true offline mobile workflows, and integrating regulatory requirements into core tools, we equip health plans to improve outcomes for members while achieving meaningful cost savings.
The release also includes UI and performance upgrades such as improved search filters, faster load times, and simplified navigation to reduce training time and improve daily workflows.
To learn more or schedule a walkthrough of TruCare 25.1 capabilities, contact us here: Contact – Zyter|TruCare.
Learn more details about 25.1 here: https://www.zyter.com/learning/releases/25-1-release/
