Built-in efficiency

UR/Case Management Module

ManageWare offers leading workers’ compensation clinical review solutions designed to support our clients at every stage of the injured workers’ continuum of care to accelerate a rapid recovery and return to work, providing maximum cost containment.

Our solutions are customized to complement and support any type of workers’ compensation program across the nation.

UR Connect Services

ManageWare offers a team of expert physicians and clinical support staff who guide our clients through the medical management process for workers’ compensation claims. Our panelists, supported by our independent clinical review platform, have the clinical expertise needed to provide reviews with evidence-based recommendations quickly and cost-effectively. Defensible, timely decisions help employers and workers’ compensation plans with cost-containment.

Our URAC accredited and HITRUST CSF, SOC & NIST compliant services include:

  • Utilization Review (Prospective, Concurrent & Retrospective)
  • Pharmacy/Drug Utilization Review
  • Medical Record/Peer Review
  • Early Compensability Assessments
  • Appeals Management
  • Determination Notifications

CareWare Technology

CareWare is a web-based, proprietary utilization review and case management system that fully integrates with our ReviewWare bill review module through a unique rules-based engine. This integration creates two-way communication between the processes, creating the most comprehensive and efficient way to insure you are getting all of the UR savings available when the medical bill is processed.

CareWare offers full utilization review management capabilities including the tracking of UR requests, approvals and denials, as well as the auto-generation of all required provider correspondence. CareWare also supports telephonic and field case management services.

CareWare’s flexible architecture allows custom configurations of:

  • Client Setup
  • User Roles
  • Workflows
  • Activity Tracking
  • Client Specific Rules

Easily access documents, notes, tasks and reminders all through CareWare, further streamlining your utilization review process.

Reporting

There is a full library of standard reports as well as a custom reporting capability available through our reporting module, ReportWare. Reports are set up on a subscription basis and generated on a preset schedule for distribution to the appropriate party. The subscription process is configured during implementation according to specific client requirements, and can be modified as necessary.