Case Management

A complete database system for tracking, managing and reporting claim status. Managing the costs of medical care is a collaborative process. Enabling everyone to share information in a secure, real-time environment provides workflow efficiencies and improves the costs of related medical care.

System Features

• Integrated module includes authorizations, plan of care and utilization review
• Plan of care by diagnosis code with begin and end date
• Data structures included for URAC certification
• Track all savings from medical case management
• Master file of protocols for authorizations
• Authorizations automatically check all lines of every bill to verify that they fall within authorized care
• Measure of Disability Management provides return to work benchmarks for well managed care and average care
• Measure effectiveness of medical case management on return to work across all case managers, individual case managers by the week, month year and by individual case or all cases
• Automatic case assignment
• Automated work flow rules by jurisdiction and client mean nothing is forgotten
• Integrated imaging system with work flow and routing, includes audit trail and attached notes
• Work queue monitoring by supervisors
• Automated fax and email of forms
• Flexible reporting
• Connect case managers from anywhere at any time
• This module is integrated into the Claims Advantage™ application