Case Management

Centralizes the creation, transmission, and tracking of clinical document packets exchanged with payers, integrating C-CDA, notes, and images.

Provides a unified view of case management and utilization review workload with real-time assignment, aging, and SLA adherence indicators.

Unified, real-time view of utilization performance, LOS, observation hours, and consult turnaround, across units, services, physicians, and payers.

Consolidates denial data by reason, payer, and service line while orchestrating on-time, evidence-based appeal submissions.

Coordinates compliant Observation↔Inpatient status changes by capturing physician–UR agreements, documentation, and timestamps required under Condition Code 44.

Provides a centralized, time-stamped record of every payer interaction, calls, faxes, uploads, and portal submissions.

Provides real-time visibility into Two-Midnight compliance by tracking admission timing, physician expectation, and supporting documentation.

Provides a real-time, data-driven command center for analyzing length of stay and avoidable days.

Provides continuous visibility into status timing and clinical triggers, flagging potential inpatient/observation mismatches early.

Standardizes medical necessity reviews by guiding clinicians through InterQual or MCG criteria capture.

Real-time visibility into in-flight denial risks, flagging missing documentation, expiring authorizations, and incomplete reviews.

Centralized workspace for managing real-time payer reviews, integrating timelines, clinical criteria, and communication logs.

Centralizes inpatient and observation status tracking, InterQual/MCG criteria alignment, and Two-Midnight rule visibility.