ProviderBASE® allows over-burdened claims adjusters and care managers to focus on the many things they need to do — while relieving them of other tasks — by providing a more optimal and automated way to:
- communicate managed care procedures and systems
- promote and monitor medical ordering ‘appropriateness’
- process authorization data and notifications
- select optimal providers/networks and direct referrals
- coordinate patient care and scheduling
- supervise expenses and outcomes through real-time reporting
- engage with all stakeholders using shared systems and information.
ProviderBASE delivers to the Workers’ Compensation industry:
- A single Platform solution that gets all stakeholders on the same page for ‘appropriate’, highly automated and rules-driven e-Ordering
- A shared Application Suite that delivers authorized referrals, notifies all parties and links with review, claims, billing and clinical systems
- Educative Guidelines at Physician/Provider levels – to improve ordering ‘appropriateness’ and reduce administrative role
- Reduced UM, Review and Prior Authorization program costs and operating expense – via a highly automated ‘triage’ review of physician orders
- Reduced Claims Administrator and Payer burden, delays, risk and expense
- Elevated PPO penetration through e-Order capture and seamless ‘hand-off’ to stakeholders and providers
- Rendering Providers are less able or likely to circumvent PPOs/Networks – increasing capture and coordination of discounts and contract rates
- Universal approach – vendor neutral & inclusive + direct-to-provider; aligns select best-of-class networks, suppliers and providers to one Platform
- Improved patient throughput and billing adjudication with Authorization status and code delivery to data/IT sources
- New IT services, solutions and performance levels across operations, systems and partners
- Elevated compliance, lower program costs, realized net savings and improved satisfaction at all levels
