Los Angeles, CA -(BusinessWire)- Effective Health Systems have announced the integration of the ODG, ACOEM, MTUS and other State specific guidelines into BaseLine’s Medical Management Platform.
Effective Health Systems’ President, James Schlueter, reported, “With this integration, BaseLine is now the most powerful and versatile technology in the workers’ compensation medical management field. The ODG and ACOEM guidelines are the backbone of almost every UR and disability management guideline today. Both have an uncontestable competence in facilitating efficacious medical procedures. Both offer valuable direction to healthcare professionals and insurance claims managers charged with restoring injured workers to a healthy and productive status. However, the two systems are very unique in how they present their case.”
“It would have been relatively easy to hyperlink the two systems and called it integration,” Schlueter said. “However, that would have been an unproductive, albeit flashy, marketing tactic. BaseLine is serious business. It serves to maximize the effectiveness of professional resources. It’s designed to provide pivotal assistance to positively impact injured workers return to health and productivity. We needed a seamless integration that was well-conceived from the user’s perspective.”
“Not an easy challenge,” noted Effective Health Systems’ COO Gregg Bernhard. “We had to create a cascading technology that accounted for the unique nature of ACOEM and ODG content; while being able to respond to the state specific regulations and client customizations. Then we faced the task of translating a significant amount of rather complex data into a format that would be immediately understandable by the user.”
“The exercise made us much stronger,” Bernhard said. “BaseLine provides almost instantaneous decisions, consistent with specific jurisdictional regulations, noting the citation underlying the decision. If something doesn’t auto-certify, BaseLine provides information managers need to determine if a higher-level review is warranted. If the manager determines the request requires a higher-level review, BaseLine can electronically transmit the request to any UR vendor. BaseLine’s bi-directional communication with vendors ensures a complete management outcome database resides within BaseLine.”
Schlueter followed-up, “Once a request is approved, BaseLine is able to recognize what the request was and who the client’s preferred vendor is. Then BaseLine can transmit the request directly to the preferred vendor, cutting out several tasks for the manager, expediting the delivery of care and eliminating leakage to outside vendors. The level of integration achieved with BaseLine has streamlined and simplified the entire medical management process.”
“BaseLine’s impact on productivity is remarkable,” said Bernhard. “BaseLine handles routine tasks and decisions instantaneously. The auto-certification application almost triples the productivity standards in most nurse review organizations. BaseLine’s ability to interact with external vendor technologies streamlines and simplifies bottlenecks in workflows. BaseLine’s networking capacity has created a completely new league in medical management technology. One of our clients found our vendor integration application alone saved adjusters about 25 hours of admin time per 100 requests processed.”
Schlueter said, “BaseLine handles the transactional details so claims professionals can effectively orchestrate the professional resources required to achieve an effective resolution. BaseLine cuts through the task-clutter and reams of data so professionals can do what they do best, MANAGE.”