Data Reporting

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Data Reporting 2017-06-29T23:09:18+00:00

Overview Facts

  • Electronic Transfer of Utilization, Case and Care Management Data
    • Daily data extract of review authorization data to claim payer system
    • Pushed to payer secure site or pulled from MCM secure site
  • Import of Plan Eligibility Data
    • Initial eligibility import prior to review implementation
    • Ongoing weekly eligibility imports
    • Pushed to MCM secure site or pulled from payer secure site
  • Thomson Reuters Case Mix Adjusted Normative Utilization Data
    • No two patients are exactly the same – how do you determine the true effectiveness of your utilization management program?
    • MCM provides gold standard data reporting benchmarks at the 50th percentile for each patient reviewed.  Benchmarking data is based on the exact age, sex, diagnoses, procedures and co-morbidities of your patient population.
    • Case Mix adjusted Benchmark data is also provided by service type, major diagnostic group and provider.
  • Quarterly, Annual or Renewal Reports
    • Scheduled to meet your needs
    • Health Risk Assessments
    • Utilization Management
    • Catastrophic Case Management
    • Chronic Condition Management
    • Health & Wellness
    • Electronic Delivery Options

Program Impact

  • Accurately Calculate Utilization Management Impact and ROI
  • Focus Review Efforts Based on Benchmark Outliers
  • Data Extracts Programmed to Your Claim System Requirements