e-Managed Care
Professionals in the disability management and medical case management fields can now spend their time delivering high quality service to their clients, instead of wasting precious resources managing their business processes.
e-Managed Care can help save time by automatically generating referral letters, reports and client correspondence using data that’s stored in the application. These documents are then kept safe and secure in the Laserfiche EDMS and can be viewed directly from the e-Managed Care application. These documents are generated using the industry-standard report writing application, Crystal Reports.
Workloads can be easily managed with e-Managed Care referral queues. Office personnel can quickly and easily assign referrals to nurses. Nurses also have the option of selecting referrals from a list of referrals.
e-Managed Care also streamlines your billing process. When the referral process is complete, invoices are automatically generated based on information stored in the application. The billing coordinator can make necessary changes to the invoices and print them. Invoices can be safely stored within Laserfiche for archival purposes.
e-Managed Care provides the following features:
Role Based Security:
- Administration: ability to add/edit/delete referrals and all items that pertain to referrals (clients, employers, accounts, statuses etc…), and manage user accounts
- Billing: access to UR (Utilization Review) and Case Management invoices
- Nurse Reviewer: access to UR lists, assigned UR referrals, assigned and outstanding UR reports, edit a majority of the data, create views, and save letters
- Nurse Manager: access to assigned cases, add billable activities to assigned cases, and generate/edit reports and/or invoices from these activities
- Tech: access to assigned UR referral, assigned and outstanding UR reports, reassign UR referral to other techs, view/edit UR referral and view, edit, and create saved letters for that referral
- Adjuster: ability to view assigned UR referrals and associated documents in Laserfiche
- Peer Reviewer: ability to view assigned UR referrals and associated documents in Laserfiche
Automated Email Notification:
Emails are generated and automatically sent to adjusters when a referral is created or assigned to a nurse.
Automated Billing:
Billing line items are automatically added to invoices based on user managed rates and specific data during the application process.
Crystal Reports Integration:
Data driven reports are generated using Crystal Reports, and can be stored in Laserfiche as TIFF’s. Report templates can be edited in the Crystal Reports designer.
Ability to customize lists in the application:
All entities (clients, adjusters, employers etc…) and lookup lists (CPT codes, review types, Review statuses etc…) that are used in the e-Managed Care can be customized to suit your needs. A list of industry-standard medical codes is provided with the e-Managed Care application.