Ensure your company is protected with the right software! // Aetna, the nation’s third-largest insurance provider with 23.1 million customers, is under fire from an investigation led by the California Insurance Commissioner, Dave Jones. While Group Health is already a stringent practice that requires adherence to several laws and regulations, one of Aetna’s reviewing [...]
As a software provider who has been in the workers' compensation industry well over a decade, DataCare has been able to address several elements that tie into the compliance of performing business as a TPA, managed care company, or a self-insured corporation. Many of our clients requested information about the security and reliability of the [...]
DATACAREʼS CASEBOOK™ is a web-based paperless, workplace for case managers. It works with your claims system or standalone, to eliminate redundant processes and save 25% of your case managersʼ time with key time saving features. REAL-TIME WINDOW INTO YOUR CASE MANAGEMENT • Complete visibility – quickly track all cases; identify late reports, upcoming deadlines, [...]
As technology continues to advance in the healthcare industry, payers and providers have gained insight on how patients can become more engaged and increase the likelihood of positive outcomes, as well as decreased costs. A recent study by the CDW Healthcare surveyed 200 patients and 200 providers, and yielded the following results: Patient-provider Communication [...]
DataCare recently surveyed several software platforms to see what they meant by the term "Mobile-friendly or Mobile-enhanced". What we observed was that the term "Mobile-friendly" is often loosely thrown around, while it simply just means that the system being used can function on a tablet or smartphone. This is not the same as a truly mobile-friendly [...]
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 [...]
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 [...]
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 [...]
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 [...]