growth in daily completed authorizations from 2023 to 2025.
22
drop in percentage of faxes due to switch to web/portal transmission
99 %
growth in Medicare Advantage daily authorizations completed
46
Affinitē Utilization Management (UM)
Affinitē Utilization Management (UM)
The Next Generation in Payer Utilization Management
Streamline prior authorization workflows, cut costs, and elevate member care with intelligent, AI-driven automation.
We are a trusted enabler of digital-first UM transformation
Affinitē Utilization Management (UM) redefines utilization management through AI-driven intelligent automation and advanced analytics that power real-time, data-driven decisions. Our innovative Benefit Query Engine delivers instant visibility into eligibility and benefits, enabling proactive and precise determinations for every authorization.
Built for the future of healthcare, the platform adapts to evolving regulatory demands with configurable, intelligent tools that enhance oversight and transparency. By connecting providers, members, and care teams through a unified digital ecosystem, Affinitē UM transforms utilization management into a predictive, collaborative process – driving smarter decisions and better outcomes across the continuum of care.
Intelligent Prior Authorization
Intuitive design and smart configuration for maximum productivity.
Benefit Query
Engine
Intelligent rules engine
dramatically streamlines
UM processes.
Appeals and
Grievances
360-degree visibility
and compliance across
all lines of business.
“I've worked in most utilization management platforms and this is the slickest and easiest to use. It's a total game changer for our Medical Directors."
Medical Director
Independent Blues Plan
The premier UM solution for health payers
Designed specifically for health payers, Affinitē UM simplifies workflows, automates complex benefit verifications, and eliminates time-consuming administrative tasks. This frees valuable clinical staff to target only those complex cases that require their expertise. Intelligent automation streamlines administrative actions so your team can operate at the top of their licensure.
- Enable high-value customer configurations to meet dynamic and varied payer needs.
- Support complex benefit design and authorization requirements to support employer specific needs and concierge care.
- Suggest modifications to benefit design and drive holistic, effective, and individualized care.
- Drive consistency across the organization through a single source of truth for data.
Transform prior authorization with an intelligent solution
that harnesses AI and advanced automation
Simplified Review Process
One-click referrals reduce review times from over an hour to less than 15 minutes.
Massive Gains in Efficiency
Our user-friendly design streamlines authorization management by up to 40%.
Real-Time Insights, Right Now
Instant insights into member benefits; track statewide
compliance in real-time.
Train Staff in Hours, Not Weeks
Our user-friendly design streamlines authorization management by up to 40%, saving significant time and money.
High-Value Configurations
Plan-specific accommodations, turnaround time compliance, benefit configuration, and auto auth rules.
Empower Clinical Systems
All authorization-related data is housed in one platform to sync care management, care gap, and other clinical systems.
Affinitē UM by the numbers
Automation that frees clinicians to focus on care,
not paperwork.
Affinitē UM’s Benefit Query Engine is a breakthrough, AI-powered rules engine that redefines how authorizations are managed. It intelligently identifies, triages, and routes requests in real time – adapting to benefit design and clinical complexity with unmatched precision. The result? Seamless process adherence, lightning-fast efficiency, and smart auto-approvals that set a new standard for utilization management.
Meet CMS-0057-F Compliance with Affinitē UM
Affinitē UM is your trusted partner in navigating the upcoming CMS-0057-F mandates, effective January 1, 2027. With our cutting-edge platform, your team can confidently stay ahead of regulatory requirements, simplifying compliance while unlocking new opportunities for success.
Designed for precision and efficiency, Affinitē UM streamlines complex processes, ensuring your organization isn’t just compliant but thrives in an evolving regulatory landscape.
Related Resources
Simplifying Prior Authorization with Technology and Innovation
Payers are working to overhaul prior authorization, according to a recent announcement from AHIP. Discover how Vital Data Technology is leading the effort with advanced, intelligent solutions.
Health Payer Guide: Prior Authorization
In this guide, we review actionable steps health plans should take to position themselves for the future state of prior authorization.
Transforming Prior Authorization: How CMS Proposes to Simplify and Automate the Process for Health Plans
Discover how CMS's push for uniform prior authorization policies and automation can improve efficiency, increase member satisfaction, and reduce administrative burdens for health plans.