Managed Care

The Managed Care Module is a valuable tool used to bridge the gap between an organization providing managed care services and a provider of care contracting to deliver services.  The ability to review contract requirements and authorizations allows a company to make informed decisions relating to total client care.

Administrative Benefits:

• Financial Planning
  • Use as a budgeting tool
  • Track Accounts Receivables
  • Track the value of outstanding authorization
  • Perform productivity analysis
• Contract Management
  • Negotiate contracts
  • Monitor profitability
  • Evaluate pricing and renewal strategies
  • Structure multiple authorization types
  • Monitor contract utilization
  • Renegotiate contracts
• Standard online reports

Clinical Benefits:

• Review benefits during treatment planning

• Relate service plan to authorization

• Remind of subsequent authorization

• Document authorization utilization

• Perform retrospective analysis of authorized versus provided treatment

Reimbursement Benefits:

• Use Benefit Wizard to give access to:
  • Client eligibility and benefits
  • Deductible, co-pay and other out-of-pocket expenses
• Bill authorized services
• Optimize rate of reimbursement
• Monitor coordination of benefits
• Track information necessary for resubmission and appeals