Mitchell, a provider of technology, connectivity and information solutions to the property & casualty claims industry, announces enhancements to the SmartAdvisor Utilization Review (UR) Decision Manager, a solution that integrates utilization review decisions within the bill review process, empowering insurance claims payers with the ability to reduce unauthorized treatment losses, improve efficiency with automated and accelerated treatment decisions, and optimize investment in utilization review technology.
"The Mitchell SmartAdvisor UR Decision Manager, like all our claims management solutions, is continually enhanced and improved in order to substantially increase straight-through processing rates,” says Nina Smith-Garmon, senior vice president and general manager of Mitchell’s workers’ compensation division. “The UR Decision Manager automatically applies utilization review recommendations to a bill, allowing manual intervention only when needed, which enabled one of our clients to reduce medical bill processing time by an impressive 30.6 per cent. The market interest for UR Decision Manager is strong and we look forward to working with our clients to help them improve operational efficiency."
The solution offers insurance payers further improvements in operational and financial efficiency with the ability to customize UR exceptions at the client, policy or claims systems level; automate compliance with New York and California treatment guidelines; and access an enhanced user interface with more granular visibility into bill entry and explanations of review (EOR) applied UR decisions.
In addition, SmartAdvisor supports the integration of third-arty systems such as Unimed, DataCare, CID Management and others into the UR Decision Manager, in order to simplify and optimize claims handling while containing costs.