Mitchell has enhanced compensation solution, SmartAdvisor Utilization Review (UR) decision manager to automate and optimise common lengthy and error-prone manual medical bill review process.
The solution automatically integrates utilization review decisions within the bill review process and reduces unauthorised treatment losses, improves efficiency with automated and accelerated treatment decisions, and optimises investment in UR technology for the insurance claims payers.
Mitchell Workers’ Compensation Solutions Division senior vice president and general manager Nina Smith-Garmon said that the UR Decision Manager automatically applies utilisation review recommendations to a bill, allowing manual intervention only when needed, which enabled one of their clients to reduce medical bill processing time by an impressive 30.6 percent.
With further enhancements, the Decision Manager provides insurance payers improved operational and financial efficiency as well as the ability to customise UR exceptions at the client, policy or claims systems level.
Additionally, the solution provides automate compliance with New York and California treatment guidelines along with enhanced user interface with more granular visibility into bill entry and Explanations of Review (EOR) applied UR decisions.
The SmartAdvisor also provides third party systems integration including Unimed, DataCare, CID Management and others into the UR Decision Manager for optimised claims handling.