Level of Care Decision

Avoid unnecessary phone calls between Managed Care and Providers

All it takes is 15 minutes of filling out our EHR to get automated LOC decisions mapped to Medical Neccessity Criteria.

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The worflow here is simple. The User fills out as much data as they can in the Health Status Indicator, they save and then mark it as complete. Once the user is sure they don't want to make any more changes, they're presented with this UI. The LOC Decision pops up and the User is given the choice on whether or not to agree with the automatically generated Level of Care and Intensity of Service. This is where a User gets to create if they choose, their own Level of Care and Intensity of Service along with a rationale as to why. We're proud to say that real world applications our aggregate percentage of Users that 'Agree' hovers near 85%.

Put managed care and providers on the same page with our tool. The Medical Necessity Criteria that insurance companies use to create their level of care guidelines is the basis for our custom algorithm, but content is king. We've spent years and thousands of man hours hammering through over a hundred thousand scenarios to give the most accurate Level of Care decision ever.

Every Level of Care decision is placed at the very beginning of every Health Status Indicator Report

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This report isn't meant to just be available to hospitals and care provider organizations. Although it's an easily readable document that can summarize an entire patient, it is meant to be shared.

By secure e-mail, fax, or internal messenging the HSI Report can be used as the first step in communicating with an Insurer/Payer or Managed Care Organization. In some cases customers reported that their Managed Care Organizations stopped calling providers and let the HSI Report speak for them. If your organization is having trouble with denials, consistant documentation, and communication with MCO's AccessHSI can deliver the solution for you and your team.