Utilization Review Software
Our utilization review solution—also known in some states as prior authorization or preauthorization—is purpose-built for workers’ compensation and managed care. It streamlines decision-making, improves compliance, and accelerates turnaround times. By automating routine tasks and reducing administrative burden, it helps review teams deliver faster, more consistent, and guideline-based determinations.
Driving Compliance and Efficiency
Meeting jurisdictional deadlines and regulatory requirements is critical in utilization review. Our software integrates state and national guidelines directly into workflows, supports client-specific rules, automates tracking of due dates, and generates audit-ready reports—helping organizations stay compliant without added manual effort.
With real-time dashboards, automated alerts, and standardized correspondence, utilization review teams can handle higher volumes of requests with greater accuracy and consistency.
Seamlessly connected with case management, medical claims management, and AI-powered document handling, our UR solution is part of DataCare’s integrated platform for end-to-end medical management.
Security You Can Count On
Within the healthcare industry, where data security is paramount, especially for HIPAA-protected information regarding patients and injured workers, DataCare’s software prioritizes the highest security standards. Its SOC 2 Certification demonstrates its commitment to secure, reliable, and confidential data handling practices, ensuring complete peace of mind for your organization.
As a SOC 2 Certified Platform, Ahshay features:
- Robust Security Protocols. Adhere to the highest security standards, ensuring that all patient and worker information is protected effectively.
- Guaranteed System Availability. Bank on dependable system performance, ensuring continuous access when you need it most.
- Assured Processing Integrity. Trust in the accuracy and completeness of your data processing, from entry to report.
- Enhanced Confidentiality. Expect the highest confidentiality standards, guaranteeing that sensitive data is always safeguarded.
Choosing our utilization review software provides more than just a solution. It offers peace of mind, knowing that security is a cornerstone of our software. This prevents your company from being prematurely excluded in the bidding process, allowing you to focus on delivering core services without the overhead of managing compliance and security measures.
Many healthcare service organizations often rely on a patchwork of disparate systems for managing preauthorization reviews. This approach often leads to inefficiencies, data silos, and potential security vulnerabilities. DataCare’s Ahshay Utilization Review Software eliminates the need for such complex integrations, providing a unified platform that streamlines workflows and ensures compliance with SOC 2 standards. This strategic approach allows your company to leverage our advanced technology and expertise without the burden of managing multiple systems and the associated security risks.
Spend more time where it counts – with the patient! Request a Demo today.
Success Stories
Our clients rely on DataCare to streamline workflows, ensure compliance, and improve outcomes. Here’s what they’ve achieved with our solutions:
Craig Bates and Susan Kennon of Timberline Medical Consultants, said, “Datacare has been an outstanding provider that meets our needs for all providers with no complaints from anyone. They provide ongoing attention for meeting increasing demand for the development of analytical reporting systems specific to our needs. Their staff of customer service, people and engineers have always been eager to help us with those needs. We believe that Datacare is the best case management software available in our industry.”
Michele Settel, President of Ascential Care Partners, emphasized, “DataCare really understands the case management and utilization review ecosystem. Their platform is robust and stable, a must-have in a systems provider. Our focus at Ascential Partners is to promote the right treatment so our patients get back to their lives using the most expedient, cost-effective, and solution-minded way. DataCare is an important partner, helping us with our mission.”
A Risk Management Supervisor said “The Datacare team is wonderful to work with and is always responsive! They continue to improve the software as well as their caliber of staff. Datacare is the best company I have worked with in a capacity of vendor because they truly care about the quality of their product and service! I would recommend Datacare to anyone looking for claims/bill review software.”
Thomas Kokkines, Vice President of Optimal Case Management, stated, “The reporting offered through Ahshay, along with the evidence-based data that ODG provides, allows us to paint a clear picture to our clients on how our nurses are positively impacting return-to-work results. The information captured in Ahshay allows us to analyze various data elements that can be useful to not just our clients, but our nurses and management.”
Sean Mullen, Senior Management Analyst, Santa Clara County, said, “Just to put this in dollars and cents, at County of Santa Clara, we experienced over $600,000 additional savings based on this new utilization review platform. That’s over $600,000 beyond what we had experienced the year before, without this automated utilization review, bill review platform.”
Our Core Solutions for Managed Care & Workers’ Comp
Medical Case Management
Our case management solution streamlines documentation, billing, and communication so case managers, supervisors, and support teams can reduce administrative work, ensure compliance, and focus on achieving better return-to-work outcomes.
Utilization Review
Built for UR teams, this solution integrates medical guidelines, tracks deadlines, and applies client-specific rules to deliver faster, compliant decisions. Automated alerts, standardized correspondence, and audit-ready reporting help organizations handle higher volumes with greater accuracy.
Medical Process Management
Our Medical Process Manager (MPM) streamlines claims-related workflows for adjusters, payers, and managed care teams. It unifies approvals, referrals, and correspondence, integrates directly with case and review processes, and reduces processing costs by improving oversight, compliance, and efficiency.
AI Document Assistant
The Intelligent Document Assistant (IDA) automates medical document indexing and summarization, reducing manual effort and turnaround time. It integrates directly into case management and utilization review workflows, improving efficiency and compliance across high-volume environments.