Envision a digital front door that always opens for the right person at the right time—securely empowering them with the data they need when they need it. It’s time to put your members in that picture and transition to a new interoperable world of meaningful engagement and participation in their health.
Smile Digital Health’s Payer Member Portal (PMP) is a secure and intuitive web application that reimagines the member experience by offering real-time, omnichannel access to and interaction with their clinical and plan data, their providers, and your organization. It delivers an exceptionally personalized, connected journey that continuously steers health care toward more value and better outcomes.
Build Value With FHIR.
It doesn't have to be complex to develop and manage a solution that combines health data from different systems, and then present it cohesively, compliantly, and securely to members on their desktop or mobile device. With PMP, you can leverage your existing CMS Patient Access Final Rule investments, including the Patient Access API, to maximize value for your organization and empower your members to do more.
FHIR is at the core of all our products, so PMP seamlessly integrates with the latest and greatest FHIR-based APIs to satisfy regulatory mandates. All while lessening the administrative burden and expense of providing comprehensive live data. In turn, members can access and interact with their complete health history—and the insights needed to make informed decisions that reduce claims and improve health outcomes.
Compete at Scale.
PMP’s leading-edge features equip and incentivize members to make informed, proactive decisions about their care—enhancing their experience, building loyalty, and improving health outcomes.
Members access PMP through a white-labelled user interface for a consistently on-brand experience that fosters stronger member-payer connections.
By compensating members with monetary incentives or physical gifts to participate in surveys or programs, they are encouraged to be more involved in their care. And you do your part to nurture relationships, realize efficiencies, and improve overall health.
Facilitate educated choices and develop loyalty by alerting specific member groups (for example, those with a chronic condition like diabetes) to significant changes or events that may affect their care or claims.
Re-engage With Certainty.
Life changes. Technology advances. Industry mandates expand. And members need to efficiently access and manage their claims and clinical data without missing a beat. When they are confidently engaged and supported in navigating their health journey, you boost satisfaction and build long-term, trusting relationships.
Members can access their clinical records, including lab results and medication history, across different providers for insight into their conditions—allowing for more effective communication and advocacy with health professionals. They can also view medical claims, including the detailed explanation of benefits, and plan allowances to monitor and prudently allocate health spending for greater value. It’s a level of transparency that fosters connections, loyalty, and retention.
Peace of mind begins at log-in. PMP supports single sign-on from other portals for seamless and fully secure access.
The portal, coupled with Smile’s FHIR repository, puts members in the driver’s seat as they manage what SMART on FHIR applications have access to their health data.
With the searchable provider directory, members can quickly find both in and out-of-network medical professionals and sidestep unforeseen out-of-pocket expenses and bottlenecks in access to care.
When individuals must entrust their health to a caregiver or loved one, PMP allows users to work with their payer to identify a delegate, like a relative or power of attorney, to access data on behalf of a member. It’s a simple way to oversee a vulnerable member’s health and potentially bridge gaps in care
Members can send and receive support messages from payer administration, allowing for responsive and personal interactions that nurture relationships.
Go Beyond.From features that deliver added personalization and control to those that cultivate more responsive and proactive care, we continuously enhance and expand PMP’s capabilities so you can consistently offer better experiences and value to your members. Roadmap features include:
Members need digital solutions to facilitate connections with providers and to efficiently navigate the healthcare system on their terms. Smile is developing a broad ecosystem of integrated applications where members can manage their own experiences in a way that best complements their care journey.
Circle of Care Management.
Low member engagement with longer-term care management programs translates into worsening health and, consequently, higher costs and lower quality ratings. It’s a lost opportunity. By centralizing the management and communication of a member's circle of care, we will provide a secure and private means for members to discuss, collaborate on, and track specific aspects of their health. This level of involvement and connectedness increases adherence to programs and protocols, improves health outcomes, and results in the more effective use of plan funds with no adverse impact on quality scores.
Data provides information. That’s a good start, but meaningful insights lead to action. As we innovate ways to extract intelligence from data sources—and automatically generate associated recommendations on actionable next steps—we will unlock added value that breeds customer satisfaction, loyalty, and healthier decisions.
Another competitive advantage lies in the opportunity for research partnerships. By enabling secure data-sharing connections for members to participate in studies with researchers, you can open a new revenue stream. It’s a win-win: not only can these funds be invested back into the organization, but your members will receive better value—directly or indirectly—through their contributions to the scientific community.