DataCare provides software solutions primarily for workers’ compensation claims organizations and for companies that serve them, such as managed care and bill review companies. The Ahshay® Platform consists of five modules which can be used together or as individual stand-alone programs. These modules streamline and automate the process of the workers’ compensation claims organization. The modules include: Medical Process Manager, Case Management, Utilization Review (“UR”), UR Enforcer™, and UR++.
Data is transferred from the user via electronic data interface or EDI, to the Ahshay Platform to be processed. The Medical Process Manager allows the user to manage and track all claims through each step of the workflow. The Nurse Case management tool is for nurse case managers to track their cases. The UR review software allows the tracking of jurisdictional turnaround times. The UR++ tool streamlines the request-for-authorization allowing for automatic adjudication and approval or electronic submission to UR. UR Enforcer identifies and notifies the bills that have not been approved, or that did not match their corresponding UR and bills that have not been submitted to UR.