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