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 and processing of medical bills”.

DataCare’s customers have been using UR Enforcer® to identify bills for treatments that were denied or never had an authorization request. They report an additional 20% saving of medical cost over their regular bill review results. One customer saved nearly two million dollars in the first year alone! Results remain consistent until today, four years after the solution was put in place. The same client still saves twice as much every year on top of all the usual fee schedule reductions, PPO’s and contract rates.

DataCare developed UR Enforcer after listening to and working closely with our customers. They helped us to identify the gap between information in the Utilization Reviews and medical bills submitted for payment. This led us to develop our UR Enforcer solution: it connects your utilization review system with bill review  to minimize this leakage by automatically verifying medical bills line-by-line against treatment authorizations from utilization reviews and precertification. We integrate with major bill review vendors provided that the utilization review authorization codes are complete and accessible.

About DataCare Corporation (https://www.datacare.com)

Headquartered in San Jose, Calif., DataCare software supports evidence-based treatment decisions with defensible supporting documentation for workers’ compensation claims. DataCare supports the highly specialized workflows for workers’ compensation claims management, case management, utilization review, and bill review systems. Web-based DataCare solutions enable reviewers to be twice as productive as those using legacy paper-based workflows, and offer managers much better visibility into status, quality, and workload issues.

By | 2017-05-26T15:03:08+00:00 September 3rd, 2013|bill review, ur enforcer|0 Comments

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