Enhanced System Capabilities
On-site Medical Management
Utilizing our proprietary System, our On-site Medical Management Program for UR, CM, DM and Wellness Programs allows customers to present on-site, full medical management capabilities while obtaining the following support, expertise, and services:
- Marketing and sales support, access to our Medical Director and panel of certified practicing physicians and specialists
- Multiple URAC accreditations and compliance with HIPAA and Department of Labor compliance
- Customized software systems and updates
- Staffing and Training
- TQM Programs
System Lease and Capabilities
Our proprietary clinical management system solution, automating data flow and connectivity between members, providers, TPAs and stop loss carriers- and improving service.
Features:
- Automated high-risk case identification and notifications to TPA and MGU/carriers
- Fully integrated Utilization Management, Case Management & Population Health Management clinical data exchange
- Automated Member & provider letter library - flexible and customizable
- Secure interface for authorization transmission to claims system
- Client Portal allowing secure real-time access to clinical work, case status and reporting
- HIPAA, PHI and HITECH compliant
Claims Analytic Tool: C.A.T.
C.A.T. is MedWatch’s proprietary data mining, analytics and reporting tool reporting on program impact and outcomes. Our rules engine combines evidence-based medicine supporting our clinical staff in providing impactful care coordination and outcomes. C.A.T. allows you to:
- View group activity and trends at a glance
- Displays group co-morbidities
- Group medical claims summary
- Individual patient medical and Rx claims detail
- Assists with wellness campaigns to the member population.
Want to see more?
Use our contact form to request a full Menu of Services from our client services team!