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++: [...]
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 [...]
Here are some of the common myths of workers' compensation. Bill review only pays for approved treatments. We see overpayment of 10-14% of medical costs after bill review reduction when UR enforcement is not automated. Are you paying for unauthorized treatments? When was the last time you did a bill review audit? UR is [...]
DataCare Customers Ahead of the Curve in Latest Survey of Workers’ Compensation Bill Review The 2012 Survey of Workers’ Compensation Bill Review by Heath Care Associates (http://www.healthstrategyassoc.com/2012BillReviewSurvey.pdf ) reports that the single biggest problem for Workers’ Compensation Bill Review is “the need to better and more completely link medical management determinations to the actual payment [...]
SAN JOSE, Calif., March 8, 2013 /PRNewswire/ — The failure of workers’ compensation claims payers to properly audit medical bills for prior approval of treatment is costing upwards of $2 billion or more annually, in unwarranted medical payments. This estimate is based on one firm’s analysis of medical payments over the past four years. In [...]
Company Experts Present Case Study at National Workers’ Comp Conference November 9-11 LAS VEGAS & SAN JOSE, Calif.--Wasting medical payments in workers’ compensation is avoidable, according to a panel of experts presenting at the National Workers' Compensation and Disability Conference® & Expo November 9-11 in Las Vegas. “Our panel will demonstrate how this connectivity can [...]