Solutions

Pre-Treatment

The Opus360 gamut of Pre-Treatment solutions includes Utilization Management, Directional Care, Concierge Services and Behavioral & Mental Health care.

Opus360 Pre-Treatment solutions work together or on their own to provide your members with options that meet them where they are, while optimizing associated costs.

Utilization Management

Key to both patient satisfaction and responsible cost-control, Hines’ trusted Utilization Management services ensure all medical services meet the highest industry standards:

  • Complete range of UM services, including: Preadmission, Concurrent and Retrospective Reviews, Discharge Planning Support, Directional Channeling and Large Case Management
  • Inpatient medical, surgical, behavioral health and substance abuse stays
  • Outpatient services, surgeries and procedures
  • Second Medical Opinion Assistance
  • Gatekeeper Service for direct provider access, Exclusive Provider Organizations (EPO) or Narrow Networks
  • Reference-based Pricing Partner Coordination
  • 24/7/365 Nurse Line

Directional Care

Whether your patients need to access quality healthcare around the world – or across the street – our Directional Care program makes sure they get the right care, at the right time, for the right cost:

  • StandbyMDTM: An innovative AI-driven platform used to direct members to the Right Care at the Right Time in the Right Location and at the Right Cost
  • Encompasses telemedicine, visiting physicians, steerage into clinics and urgent care centers
  • Guiding members to quality, cost effective providers, including providers who offer competitive reimbursement agreements
  • Triggers effective cost management with upfront negotiations and bundled payments
  • Accessed through our 24/7 call center, through the StandbyMDTM app or embedded in your member app with proven APIs
  • Available worldwide

Concierge Services

Hines’ sought-after Concierge Services offer all the rigor, flexibility and sophistication your patients expect, with the added warmth of human touch:

  • A customized range of bespoke services
  • Member Advocacy by guiding and educating members through the complex U.S. healthcare system
  • Complete 24/7/365 assistance and claims management services globally

Medical Second Opinion

Hines’ is pleased to offer you and your patients highly qualified medical reviews in multiple fields of expertise:

  • Hines has a full spectrum of board-certified physicians that make up our panel of experts
  • Coordinating and delivering in-depth reviews for any case, including multiple specialties