Are You Prepared For Senate Bill 1160?

This letter is to address the impact of Senate Bill 1160 (or SB1160) pertaining to self-insureds, TPA’s or third-party-administrators, employers, and utilization review organizations across California. On September 30, 2016, SB1160 was signed by Governor Jerry Brown, which is set for implementation beginning the first of January in 2018. The result of this bill will [...]

Drug Formulary: Quick and Easy Approvals with UR++

Express authorizations can be performed faster and more easily with the use of drug formularies. The recent release of the California Drug Formulary uses a very objective language suitable for fully- or partially-automated approval of requests. For example, after entering a medication request in DataCare’s UR++ system, the system can easily determine if the request should [...]

By | 2017-06-27T20:53:06-04:00 June 27th, 2017|adjusters, express approval, regulatory, UR software, ur++|0 Comments

Cutting Complexity in Workers’ Compensation Utilization Review Programs

DataCare UR++SM reduces utilization review program costs by enabling claims adjusters and trained administrators to routinely approve 80% or more of all treatment requests and by significantly reducing the number of referrals to more expensive nurse or physician reviews. Quick approvals also shorten the time it takes for employees to return to work. With the UR++: [...]

Does Your Utilization Review Team Have the Tools It Needs?

Utilization review (UR) organizations need to coordinate the efforts of highly skilled professionals on a tight timetable. This makes modern technology a requirement for a top-performing team. According to Dr. Doug Benner, who led Kaiserʼs occupational health services for 30 years and now serves as medical business product development officer at EK Health, the California-based, [...]

By | 2017-05-26T15:03:06-04:00 April 28th, 2017|case study, press release, UR software, ur++|0 Comments

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 | 2017-05-26T15:03:06-04:00 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 | 2017-05-26T15:03:06-04:00 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 | 2017-05-26T15:03:06-04:00 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 | 2017-05-26T15:03:06-04:00 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 | 2017-05-26T15:03:06-04:00 September 28th, 2016|press release|0 Comments