Fully Integrated with Referral & Eligibility Systems

Access Express provides the tools you need to identify and manage high-cost patients efficiently because case management is fully integrated into the UM process.

 

Members can be selected for case management by the UM staff or automatically assigned based on diagnoses, procedures, or other variables. Once a member is identified by the system, all UM screens are tagged to alert the UM and claims staff that the member is actively managed and may require special attention.

Clinical Pathways and Case Management Summary
Keep Data Just One Click Away

Built-in clinical pathways ensure that patient information is collected correctly and completely by case managers. They provide basic contact information for patients and caregivers. Clinical Pathways can request the case manager to identify the providers and protocols required by each health plan for high-cost items like medical devices or chemotherapy.

 

Pathway queries cover a range of diagnoses and treatment options that vary by medical group and health plan. Once collected, all the information is one click away in the Case Management Summary with easy access to pathways & extensive notes/attachments including electronic images that have been forwarded to medical management. Material in the Case Management system can be easily searched using medical and lay terminology, diagnostic or procedural codes.