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DecisionUR™

Decision UR Application

Utilization Review Platform


DUR-Automation

Automation

Medical Treatment requests are appropriately auto-approved for prior authorization.

DUR-Customized

Customizable

Automated approval process is configured with your business rules to enhance efficiency.

DUR-Reliability

Reliability

DesicionUR is timely, accurate, and consistent with an uptime of 99.99% for the past 10 years.

About DecisionUR™

DecisionUR is a cloud based solution that stores and utilizes state mandated evidence based medical guidelines to automate initial treatment reviews, and streamlines the entire UR Management process. DecisionUR was the first product on the market to offer an automated approval system that transmits requests directly to the appropriate URO and/or IRO.

Who Needs DecisionUR?

  • Payors
  • Self-Insured
  • Third Party Administrators
  • Managed Care Organizations
  • IRO/URO

How Does DecisionUR Work?

We configure a private label platform within days, based on your custom workflow and business process. We will help configure the necessary letter templates and assign necessary evidence based guidelines for your specific needs. All you need is a browser and internet connectivity and you can start using the DecisionUR platform almost immediately from anywhere or anytime. You will be assigned an account manager and customer service representative for any questions or request.

How Reliable and Secure is DecisionUR?

DecisionUR has been in production for 10 years with uptime of 99.99%. We support the highest level for Secured Socket Layer (SSL), Encryption at Rest and Role based security.

DUR-application

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DecisionUR Highlights

  • DecisionUR controls cost of UR, increases patient care, reduces fraud, and helps provide a better turnaround time.
  • Brings consistency to UR with easy to use Software as a Service (SaaS).
  • Access to Occupational Disability Guidelines, American College of Occupational Environmental Medicine, Medical Treatment Utilization Schedules, New York, Louisiana, Colorado evidence based medical guidelines.
  • Ability to create and store custom protocols to help develop appropriate automated approval processes.
  • Automated assignment to PEER/2nd level review based on your own business rules.
  • Digital collaboration tools- documents, alerts, diary notes, etc.
  • Integration with several ancillary partners like OneCall Medical, WellsComp, MyMatrixx, Align Direct, SpNet, SMS Natational, Express Script and many more.
  • Integration with several bill review organizations like Mitchell, CompIQ, StrataCare, etc. to eliminate medical bill review leakage.
  • Ability to bridge most claims systems for accurate claim management.
  • Advance Reporting & Performance Matrix.