BaseLine UR 

Utilization Review is a constantly changing & ever-evolving business 

Utilization Review involves a medical review process heavily regulated by state agencies and accreditation organizations such as URAC.  Further, each state has its own different and distinct rules for the same situation that plays out in every other state, which exponentially complicates the issues for UR companies that practice in multiple states.  Keeping this all straight is a nightmare.  But, keeping the rules straight is incredibly important since state regulators are not known to forgive errors in the UR process lightly.

Further, most UR software companies only serve the limited focus of the actual UR requirements. Thus, they ignore most of the essential external tools the nurse managers require to complete their jobs effectively.  A complete lack of business intelligence resources is necessary to manage all the many details that keep your business moving forward while avoiding choppy waters.  This situation leaves many UR managers and practitioners dealing with disintegrated data and software programs that don't play well together.

 

BaseLine's medical authorization application offers everything necessary to address those kinds of issues.  These include such features as:

  • Automated Claims Eligibility Validation

  • Automated Medical Triage Support

  • Integration to 3rd Party Guideline Tools

  • Integrated connection to UR & Peer Reviewers

  • Integrated connections to 3rd Party Service Providers for Approved Requests

  • Automated Bill Review Data Integration

  • Flexible Rules Capabilities to Ensure Compliance With Regulatory & Business Rules

  • Letter & Documents Management 

  • Compliance Tracking & Reporting Support

  • Internal/External Appeals Process Management

  • Automated Locality-Based Pricing Data for Savings Reports

BaseLine UR Modules provide additional support for the business end of UR management.  They include features as:

  • Automated Nurse/Case Assignment

  • Credential Monitoring

  • Claim level Notes / SOAP Notes

  • Time Tracking for Billing

  • Business Intelligence Analytics

 

BaseLine also supports integration with multiple claims systems to fully automate and streamline the review process.

Hello!

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I'm Don Adams, the CRO with EHS. 

 

In today's world, the competence of your technology systems will make or break your business.   Every day we are hearing stories of how growing medical management and UR companies are using their technology to distinguish their businesses from their competitors.  Let's face it, technology is the new table stakes to survive and thrive in this business.

 

We can make technology work for you.  Drop me a line.  I would love to visit with you about your business.  We have a way of leveling most speedbumps so you can get on building your business rather than managing urgent but non-productive problems.

 

Drop me an email.  We can make this happen quickly for you.