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 [...]

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 [...]

DataCare's Ahshay platform provides automation, visibility, and ultimately, cost savings for your company. However, you won’t see ROI in your investment unless you’re actively taking advantage of the visibility it provides. You now have the power to view, analyze, and take action on a huge range of data. Actively monitoring and making decisions based [...]

Between complying with the new regulations, mounting medical inflation and the need to find creative ways to manage cases, claims administrators everywhere have their hands full. As a result of added complexities in the claims world, the importance of increased organizational efficiency has never been as clear as it is today.  When a company [...]

SAN JOSE, Calif., May 14, 2013 /PRNewswire/ Reed Group® MDGuidelines are featured in DataCare's latest whitepaper "Calculating Hard-Dollar Returns on Return-to-Work Case Management".  In today's competitive business climate, a managed care company must provide empirical data that supports its ability to control costs, increase efficiency, and increase the quality of care. The key metrics [...]

Sean Mullen, Senior Management Analyst at Santa Clara County features DataCare's UR Enforcer and Express Approval Software to explain how they were able to save 11% in medical claims by connection UR with BR and eliminating common over-payment. https://vimeo.com/130391007

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 [...]

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. [...]

Addresses Financial Impact of Disconnect Between Utilization Review and Bill Review DataCare Corporation, a leading developer of software for the workers’ compensation market, announced the release of UR Enforcer™ . This new application augments traditional bill review services and has documented savings of up to an additional 20% of medical expenses by verifying bills [...]