Alicare Medical Management’s provider portal, which is supported through AcuExchange, allows us to respond to a providers’ utilization management requests in real time.
Auburn, CA & White Plains, NY (PRWEB) July 11, 2012
Alicare Medical Management (AMM), one of the nation’s leading care management organizations, announces the successful implementation of TCS Healthcare Technologies’ (TCS) AcuExchange™ tool, an online provider request system. AcuExchange is a web-based portal that allows providers to review eligibility information, submit utilization management (UM) requests for patients, and communicate with reviewers about a patient’s health and services.
“Alicare Medical Management supports the health care programs for diverse clients and needs to be able to support and respond to the needs of attending health care providers,” says Claire Levitt, AMM president. “As part of that mission, Alicare Medical Management’s provider portal, which is supported through AcuExchange, allows us to respond to a providers’ utilization management requests in real time. The online tool was specifically rolled out to support a new initiative for a Medicare Advantage program, but has application throughout our care management operation.”
The Alicare Medical Management/TCS partnership allows providers to:
- Submit UM requests for both inpatient & outpatient services
- Submit change requests for previous UM requests
- See all requests they or their groups are associated with
- Review prior UM requests and eligibility information
- Submit attachments, notes and assessments to document requests
- Send and receive messages to utilization review staff
- Print reports
“AcuExchange, in conjunction with our flagship application Acuity Advanced Care®, allows users to configure screens for provider data entry, offers a HIPAA-compliant data exchange, uses a secure log-in process for providers, and integrates with Acuity in real-time, among other benefits,” according to Rob Pock, TCS president and co-founder. He adds that AcuExchange relieves some of the pressure from the payer by giving ordering providers instant certification and/or otherwise identifying the next steps.
“By leveraging technology with health care, AcuExchange allows us to electronically submit utilization management requests, increasing the timeliness and efficiency of provider requests,” says Julie O’Brien, AMM vice president and COO. “This application provides us even more flexibility and puts AMM ahead of the curve with electronic submission. It also supports mainstream UM transactions and specialty services.”
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Alicare Medical Management (http://www.alicaremed.com) is a member of the Amalgamated Family of Companies, is a national leader in developing care management solutions that promote cost savings and patient satisfaction. AMM’s call center is open 24 hours a day, 365 days a year to provide maximum access and assure optimum program effectiveness. The company’s services include: 24-hour Nurse HelpLine, Utilization Management, Maternity Management, Case Management, Disease Management, Health Coaching and Wellness, Independent Physician Review, Medical Claims Review and Hospital Bill Auditing. AMM holds four URAC accreditations for Utilization Management, Case Management, Health Call Center and Independent Review.
TCS Healthcare Technologies (http://www.tcshealthcare.com) is a leading provider of software and clinical solutions that support and improve population health management strategies for health plans, insurers, providers, third party administrators, medical management companies, and others. TCS is recognized as one of the premier health care software companies in the United States designing, offering, and hosting a number of products and services. The TCS Acuity Advanced Care® application provides a comprehensive and integrated care management software system for Utilization Management (UM), Case Management (CM), Disease Management (DM), and Prevention/Wellness (PW) services.