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

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 [...]

Top 10 Reports to Improve Your 2016 Planning

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 on [...]

By | 2017-05-26T15:03:07-04:00 February 26th, 2016|reports, UR software|0 Comments

ICD10 Support

DataCare's Ahshay platform supports ICD9 and ICD10 codes for both UR and CM. We have a superb track record of smoothly managing the big health care industry changes for our clients. DataCare will work with you to: Make it clear what ICD10 is Help evaluate whether and when you should convert Deliver a seamless transition [...]

By | 2017-08-31T16:37:29-04:00 April 21st, 2014|case management, ICD10, ICD9, UR software|0 Comments

Busting Myths in Workers’ Comp

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 [...]

Bill Review Silos Cost Payers Over $2 Billion

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 [...]

Mitchell Selects DataCare Case Management and Utilization Review Software for Excellence in Innovation

SAN JOSE, Calif., Aug. 19, 2011 -- After a thorough evaluation, Mitchell Workers' Compensation Solutions has selected DataCare’s Utilization Review (UR) and Case Management Software for its managed care operations. Mitchell Workers' Compensation Solutions, a division of Mitchell International, is a leading provider of workers' compensation cost-containment technologies and services. Insurance payers, self insured companies, [...]