A leading oncology care provider operating under a capitated payer model faced mounting challenges in chemotherapy utilization management. Manual reviews for payer alignment, FDA indication validation, and biosimilar preferences slowed down authorization cycles and increased administrative burden.
Through its partnership with GetOnCRM, the provider embedded utilization management directly into salesforce health cloud/ chemo authorization workflows. This transformation automated contract checks, streamlined FDA and regimen validations, and standardized biosimilar review processes. The outcome: faster turnaround times, consistent compliance, and reduced manual effort, enabling providers to focus more on patient care while ensuring financial and regulatory alignment.
A US-based oncology care provider, operating under a capitation-based payor model, required a stronger foundation for managing chemotherapy utilization management (UM) cases. The existing CRM setup lacked structured workflows, making it difficult to track authorizations, coordinate with providers, and ensure compliance.
The organization turned to salesforce healthcare solutions to establish a scalable, standardized UM process aligned with its strategic priorities, particularly Salesforce Health Cloud utilization management and Salesforce Experience Cloud healthcare integrations.
These challenges created longer turnaround times, increased administrative work, and limited visibility for clinical reviewers—directly impacting efficiency in oncology patient care Salesforce workflows.
All UM requests, status updates, and review history tracked in one system.
Automated updates for payor drug lists and switch crosswalks.
Capitation-specific biosimilar references surfaced during case reviews.
Role-based dashboards provided physicians with timely data.
Simplified review processes for better efficiency.
Audit-ready workflows and regulatory-grade protections improved trust.
Secure self-service portals support oncology patients.
Supports scaling personalization in healthcare through dynamic workflows.
Salesforce Health Cloud and Experience Cloud integration for oncology enables seamless coordination.
Built-in referral-management-system and behavioral health referral management salesforce features ensure care continuity.
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