Making the UR process simple and efficient

DataCare’s Utilization Review Software helps to significantly lowers costs and turnaround time by speeding up communication between the URO and requesting physician.

DataCare’s Utilization Review is a web-based paperless, electronic workplace for your healthcare professionals that eliminate redundant processes. With this platform, UR organizations are able to make justified decisions in half the time. The UR platform incorporates your medical guidelines right into the workflow and will keep track of and report on all of your jurisdictional turnaround times, letting you know which requests are coming due and how fast your company is getting them out. Ahshay will store and generate the specific state/jurisdictional templates and letters in the system so compliance is not an issue. DataCare also provides reports to help with audits and to help ensure URAC accreditation.

  • Productivity – Auto generate determination letters with integrated guidelines, attach/send directly from the system via email/fax, or refer to reviewing physicians internally in Ahshay.
  • Visibility – Users have the ability to track medical history and documents, case turnaround time, as well as patients that have to be referred for Case Management. All of this information can be viewed either from a nurse, case manager, or reviewing physician level.
  • Advanced Analytics – The Ahshay Platform will incorporate all state and jurisdiction turnaround times on the front end and track them for your company. One click simply reports to have a comprehensive view on various turnaround times, requesting physician scorecards, reports for audits/URAC accreditation, and more.
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utilization review

utilization review

Standardized Workflow & Efficiency

  • Cost-Savings Analytics – Track how much was saved in real-time based off state fee schedules for requests that were denied.
  • The UR platform allows the user to generate letters for the physician, which can be sent out directly from within the system.
  • The system provides integrated evidence-based guidelines that support CPT treatment codes.
  • Provides an easy way to track and monitor the progress for each case.
  • Utilizes Ahshay electronic workplace and can be integrated with other DataCare programs, or can be purchased as a standalone.
  • DataCare has wide experience integrating with claims, bill review, and internal client systems enabling real-time data exchange

A Safe, Secure, and Reliable Utilization Review Platform

DataCare solutions are built on the Ahshay® Platform which enable claims tracking through all steps of the process: case management, pre-authorization, utilization review, and bill payment. Ahshay® is configurable to your workflow and offers seamless integration with major claims and bill review systems. DataCare offers SaaS solutions that run on every major browser including tablets and smartphones.

utilization review