Case Management System
iCase360 is a case management tool which helps third party administrators and independent case administrators to effectively process workmen compensation or vocational rehabilitation cases from inception to case closure with a core objective of a successful return to
work of the injured worker.
This tool allows Case Manager or Vocational Rehabilitation Specialists to –
- Register Case
- Follow a pre-defined standard operating procedure for the execution of case
- Log all case management activities being performed for the case
- Generate case forms or reports (controlled by either BWC or TPA defined)
- Invoicing of a case (CMS-1500 for BWC cases or predefined format of the TPA)
- Continuous follow up (Facilitate effective decision making via Dashboards showcasing KPI)
- Case settlement and closure
The overall domain of workmen compensation revolves around effective collaboration between the Case Manager with Injured Worker, Employer, Physician and other parties such as Insurance Company, Attorney, MCO, TPA, BWC, Non-Profit Organization & External Case Manager.
Case Manager and/or Vocational Rehabilitation Specialists ensures close monitoring and controlling of workmen compensation costs by providing a comprehensive rehabilitation plan intended for the Injured Worker and Employer. This eventually helps reducing long term cost and associated risks for the stakeholders and effective Return to Work for the Injured Worker.
Following features provides a complete solution to help organization in standardizing their day to day case management or vocational rehabilitation activities –
1) Sample Dashboard
- High-level summary of the current month progress - New Cases, Inactive Cases, Invoiced, Pending Cases for Invoicing & Pending Tasks.
- Derive the summary (by the week / month / quarter / year) of all open cases by service line along with a drill down by specific case status.
- List of all tasks allocated to the Case Manager. These tasks are flagged as per the timeline of completion i.e., tasks scheduled to complete Today, Next 7 Days, Next 14 Days, Thereafter or Overdue along with Closed or Unscheduled tasks. Case Manager can also reassign the task to other case managers as per current workload.
- Comprehensive case registration and tracking process for Case Managers.
- Standardization of case management processes via implementation of standard operating procedures.
- Using google maps plotting of various stakeholders of a case with a central focus on the injured worker.
- Consolidated billing tracker to track costs incurred for case manager and vocational rehab specialists in the process of execution of the case.
- All tasks are assigned to either a case manager or vocational rehab specialists for a given case.
- All tasks are mapped to an accounting code (Professional / Wait / Travel / Mileage) for automation in the process of invoicing.
- System automatically sends email alert to the task owners to remind about the task completion.
- Case managers and vocational rehab specialists enter detailed case progress notes.
- These progress notes are used as a case tracker of work executed by case managers in the process of return to work for the injured worker.
- These progress notes are mapped to the relevant accounting code (Professional / Wait / Travel / Mileage) which is leveraged in the process of invoicing.
- Progress note category can be assigned to state the type of category the progress notes can be assigned e.g. Case Manager Notes, Employer Notes, IW Notes, NP Notes …etc.
- Case Forms allows user to generate reports (PDF) with case information. These forms are predefined by the type of job of a case.
- These forms are either controlled by BWC or defined & managed by the TPA or case management company.
- Case Forms can be generated 1..n times and all revisions are maintained with in system boundaries.
- Users can download or email the forms directly from the system.
- Invoices are managed by Billing Specialist user.
- System displays appropriate alerts if any billable items (i.e., progress notes) has exceeded the predefined limits.
- User has a capacity to override predefined limits.
- Invoices are generated as per predefined template setup by BWC i.e., CMS-1500 for state funded cases.
- User can view non-billable progress notes and decide if they need to mark them as billable items.
- User can also transfer Self-Insured invoices to Quick Books with push mechanism along with detailed status of the invoice transfer.
- Case Documents
- Manage documents uploaded by case managers and vocational rehab specialists.
- User can upload document to a case and it will be available to any & all who has access to the case.
- Case Emails
- Manage emails sent by case managers, vocational rehab specialists & billing specialists.
- User can send email from the system such as any documents or invoices to any contact.
- Allows users to export (as per data filter criteria) all tasks in the system along with relevant information to an excel worksheet.
- Progress notes
- Allows users to export (as per data filter criteria) all progress notes in the system along with relevant information to an excel worksheet.
- Allows users to export (as per data filter criteria) all contacts in the system along with relevant information to an excel worksheet.
- Allows users to export (as per data filter criteria) all cases in the system along with relevant information to an excel worksheet.
- Billing (Pending)
- Allows users to export (as per data filter criteria) all pending billing items i.e., progress notes in the system along with relevant information to an excel worksheet.
- Billing (Completed)
- Allows users to export (as per data filter criteria) all completed billing items i.e., progress notes in the system along with relevant information to an excel worksheet.
- Billing (Non-Billable)
- Allows users to export (as per data filter criteria) all non-billable items i.e., progress notes in the system along with relevant information to an excel worksheet.
- Billing (Cancelled)
- Allows users to export (as per data filter criteria) all cancelled invoices i.e., progress notes earlier billed later cancelled in the system along with relevant information to an excel worksheet.
- Master Billing Codes
- Allows users to export all master billing / accounting codes which drives the invoicing rules in the process of billing.
- Client Billing Codes
- Allows users to export all client specific master billing / accounting codeswhich drives the invoicing rules in the process of billing customized for a specific client.
- Case Status Tracker
- Allows users to export (as per data filter criteria) all history of status changes for individual cases in the system along with relevant information to an excel worksheet.
- Case Load Report
- Allows users to export (as per data filter criteria) the current load/allocation of cases by the type of case along with the status across all case managers in the system.
- RTW Plus Tracker
- Allows users to export the latest status of all RTW+ cases including status on NP placement along with detailed information such as NP placement information, Case Manager Hours / Fee / Mileage / Invoice, Closure Details …etc.
- Forms Master
- Allows users to view templates of forms / reports.
- These forms are categorized as per the type of job or service line i.e., Self-Insured, State Fund, RTW+, JD, JP, JSST, RAW, Task Assignment, TWP, Vocational Evaluation and TCM.
- These templates are used for generating reports in the process of case life cycle.
- These templates are system controlled.
- Contacts such as Attorney, BWC, Employer, Insurance Company, MCO, Physician, TPA, Non-Profit Organization and External Case Manager can be managed from the contact master.
- These stakeholders are further utilized in the process of registering a case.
- Contact can have custom reports (like form master) which can be utilized in the process of case life cycle.
- Master Billing Codes
- To manage billing or accounting codes by billing specialist.
- User can create new custom group and billing items along with rules such as
- Min and Max limits (Units) and Dollar Cost (Per Unit)
- Billable? (Yes or No)
- Applicable to which Service Line
- Applicable to which Case Status
- Rehab Code (BWC Controlled) and RAW Code
- New Rate Applicable Date & Dollar Cost
- Quick Books Dollar Cost
- Case Manager and Vocational Rehab Specialists uses these billing or accounting codes in the process of entering progress notes.
- Invoice generation uses these rules defined to generate invoices.
- Client Billing Codes
- Custom billing codes are often created to give special rates to high value clients.
- Billing Tracker Rates
- These rates are used in the process of calculating the amount payable to the case managers or vocational rehab specialists.
- Employee Rates
- Information such as QB Item & Class (QB Integration), Type (Full / Part), Accounting Code, Pay Rate (Hourly), Bonus, No. of Hours in a week …etc.
- This information is used in the process of transferring Self-Insured invoices to Quick Books.
- Company Information
- Detailed information about the company – Company Header, Contact Information, Billing & Invoicing details.
- Additional offices can also be setup.
- User Setup
- An interface to allow Web Administrator to setup users who will have predefined access to the system as per roles allocated.
- Users can be assigned one to many roles in the system.
- Pick List and Dependent Pick List
- An interface to allow Web Administrator to manage the picklist OR drop down values in the system.