Streaming data allows for near instantaneous decision making for claims management. In a previous post entitled, "It's Getting Closer...effective mining of Workers' Compensation Claims", it was pointed out that more data was needed to accurately forecast claim severity. One key element cited was Evidence Based Medicine from the treating physician.
Processing patient record information between medical professionals and health care management organization requires timely tenuous phone conversations, photocopying and documentation. The HMonline Electronic Referral and Precertification Management programs establish a portal for streamlining the exchange of information on a real-time basis - 24/7/365. This reduces overhead and enhances efficiency.
The HMonline Electronic Report Submission program allows medical professionals to submit clinical notes associated with the care provided and linked to requests for reimbursement. These documents are connected within the HMonline database and made available to third parties. There is no need for resubmission, additional copying, mailing or distractive phone conversations with third party management organizations. Likewise, management organizations have easy access to vital information without the need for contacting point of service provider offices and can easily communicate this information with legal counsel, case managers, IME vendors and employers.
This streaming data is collected by the physician, at time of treatment, and sent forward to the insurer. And. the best part...the data is collected and provided for free. So, perhaps one more piece of the puzzle is solved.
Now all that remains....can you assess the emotional state of an injured worker?