@Global's New Claims Product Completes the Workers' Comp Care Management Cycle
AT @Global, Inc. has released a workers' compensation claims product as part of its Allegro suite of care management software. When bundled with the total Allegro package, it completes an integrated, all-in-one solution to care management, medical bill review and claims.
A natural outgrowth of the Allegro care management application, the claims software brings a patient-centric approach to the way people see and use data. When an adjuster or nurse case manager pulls up a claim, the system presents an entire history instead of a mere snap shot of the claim in that moment in time.
"The user reviews each and every step and data change from the time the claim is opened right up to the current situation. This unique, overall view provides adjusters and care managers with the tools to resolve claims in a much more timely, efficient and cost-effective manner," said Steve Graham, president of @Global. "Armed with all the pertinent information, an adjuster or case manager can tailor claims administration, care management and the return-to-work process to the individual, instead of forcing the claimant to fit a mold based on partial information."
Graham stressed that @Global designed its claims product as a logical extension of care, while many developers create case management as a secondary product. Until now most claims software companies approached medical management as an afterthought, attempting to retrofit care management to the claims process.
Allegro's claims software can also call attention to unusual items, such as repeated referrals to certain physicians or unusual reserving edits. " Because it is so easily configured, users can set up their own criteria to identify any cases that fall outside of pre-determined standards," Graham said.
The software includes an enhanced billing system for flexible contracting arrangements. "You can set up hourly-fee billing for one client, capitation for another, and a per-claim basis for a third," Graham said, noting that creative billing options gives organizations using Allegro a significant competitive advantage when courting prospects.
User friendly data presentation is another product distinction. "You can query medical bills from many different spots in the system. You don't have to go through a hierarchy of cascading menus and screens or open and close a lot of files to get to the information you need," Graham said.
Like the rest of the Allegro suite, the claims software runs on Windows and Microsoft Back Office platforms, making it popular with users and IT departments alike. In addition, all the systems have been developed with Y2K-compliant architecture, coding and documentation. @Global is also developing claims products for short- and long-term disability and group health applications.
Allegro is an advanced, three-tier client/server software package that integrates care management for workers' compensation, group health and short- and long-term disability benefits into a single solution that promotes uniform care, regardless of the nature or origin of the injury or illness. Its unique patient-centric design links all elements of a case -- demographic data, treatment plans, medical guidelines, return-to-work schedules, physicians orders, and managed care requirements -- to the patient.
Based in Fort Lauderdale, Florida, @Global serves managed care organizations, insurance companies, case management firms, third-party administrators and other organizations involved in the delivery and payment of healthcare services.