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UR++ 1.4 for Adjusters and Claims Professionals

DataCare is proud to present its latest release for Adjusters and Claims Professionals: UR++ 1.4 WHAT'S NEW Adjusters/ Claims Professionals come across several Request for Authorizations (RFAs) each day, and some cases may require additional attention. For this reason, the latest version of UR++ enables clients to incorporate a best practices ruleset to make approvals [...]

By |March 24th, 2017|adjusters, insurance, press release, ur++|0 Comments

Track Bills with Increased Visibility

The Bill Review or BR process consists of several stages that require close monitoring to ensure repricing and payments meet the state mandated turnaround times. BR Specialists may keep track of when bills come into the system during the KFI or Key-for-Information stage, but the high volume of reviews can make it difficult for them to monitor [...]

By |February 23rd, 2017|bill review, press release|0 Comments

Ascential Care’s software needs met by Datacare’s Ashay Platform

DataCare takes pride in being able to support many companies including Ascential Care in achieving an optimal day-to-day workflow for Case Management and Utilization Review. Ascential’s need for software first arose when they began operating in the managed care industry and manual data entry was an unnecessary evil they initially faced. The lack of a [...]

By |January 9th, 2017|case management, press release|0 Comments

Benefits of Integrating CM, UR and Adjuster Software Modules

Companies involved in Workers’ Compensation will typically use Utilization Review, Case Management and Claims Management software independent of one another. The Ahshay core software platform achieves higher efficiency, savings, and detailed reporting by combining these modules under one platform. Within DataCare‘s core platform Ahshay, Utilization Review, Case Management, and the claim enhancing Medical Process Manager [...]

Balancing Medical Spending and Necessity With the Cost of Referring to UR

Time after time, adjusting offices find themselves asking the same question: “Should we approve this request for physical therapy, or is it worth sending to UR? We usually just go ahead and approve these, but we have been seeing PT requests for this patient pop up an awful lot this past month… Let’s just approve [...]

By |October 14th, 2016|adjusters, insurance, press release, ur++|0 Comments

DataCare Stays Current With Updates to Medical Treatment Guidelines

In an effort to reduce the delays incurred during the treatment process for injured workers, the DWC has been continuing to update medical guidelines to align with the workers compensation drug formulary as required by Assembly Bill 1124. DIR Director Christine Baker mentioned that the drug formulary will serve as a guide for medical providers, [...]

By |September 28th, 2016|press release|0 Comments

DataCare Article featured on WorkCompWire

Source: WorkCompWire San Jose, CA – DataCare’s recently announced that its web-based workers’ compensation case management software is integrating the Reed Group® MDGuidelines. MDGuidelines offers: Real-world and physiological return-to-work duration Predictive modeling of return-to-work duration Medical monographs for clinician reference and patient education State treatment guidelines for workers’ compensation Leave of Absence Advisor™, a resource [...]

By |June 7th, 2016|case management, press release, return to work|0 Comments

What drives RTW?

Top Factors Impacting Return to Work Some might think that determining when a disabled patient will return to work is a matter of luck. Fortunately, you don’t have to roll the dice to have an estimate on how long someone will be out of commission from a disability or injury. Through years or collecting data [...]

By |June 2nd, 2016|case management, rtw savings|0 Comments

Why pay $3.5 million in penalties?

$8 million loss… Where did it come from? As of March 10th , 2016, several third-party administrative agencies face over $8 million in fines for allegedly failing to provide necessary medical documentation in time for independent medical review (IMR). A great deal of risk is involved when managing a large database of medical records if [...]

By |March 28th, 2016|Uncategorized|0 Comments

When is the UR Enforcer Necessary?

Workers comp administrators receive 200 to 300 bills a day which need to be directed to adjusters. However, the adjusters don't necessarily review the bill, even though numerous incidents occur when they are sent out for the wrong reason. Some of these reasons may include a bill for unnecessary treatments, fee schedules changing frequently, or even when [...]

By |March 2nd, 2016|ur enforcer|0 Comments