SMART-UR launches Client Service Center to assist with medical Utilization Review request process

Gregg Bernhard, COO of SMART-UR (www.smart-ur.com), announced the company has launched a Client Services Center to assist its clients with the processing of medical Utilization Review (UR) requests.

“UR is the only effective strategy to prospectively control the escalating medical costs in workers compensation. Unfortunately”

"UR is the only effective strategy to prospectively control the escalating medical costs in workers compensation. Unfortunately," Bernhard said, "traditional UR methodologies add an incredible burden to the system in terms of added costs of operation and delays in treatments that are clearly medically necessary."

Smart-UR addresses the inefficiencies in traditional UR by being able to immediately target and process those requests that will be determined necessary under any jurisdiction. Bernhard said, "Smart-UR is able to effectively clean out about 60% of the requests that are currently being sent on to UR vendors by most insurers. Subsequently, SMART-UR expedites the delivery of care for injured workers while significantly reducing the cost of operations and streamlining workflows for the insured."

"The Service Center concept came up while visiting with some of our clients who loved the way in which SMART-UR had streamlined the UR process in their claims centers. Our clients were looking for ways to gain even more efficiencies so their claims staff could focus more time and attention to managing claims versus processing UR paperwork." Bernhard said. "That led to the idea of creating a Service Center that can receive all UR requests, complete the basic data entry for the adjuster and then let the technology handle the process per the company's protocols, which include escalating questionable requests on to any external UR vendor."

Rob Shatsnider, Vice President of WC Claims at CompWest Insurance Company (www.compwestinsurance.com) , noted that the SMART-UR Technology made dramatic impact in his company's UR operating costs as well as greatly speeding up the decision process to deliver quality care to the Injured Worker. He said, "The SMART-UR targeting technology has eliminated most of those requests that were being referred out to our UR vendors only to be approved. Now, we are only sending out those requests where there is a reasonable question as to the medical necessity of a request based on medical protocols at the ICD9 level."

According to Shatsnider, "We still wanted to find a way to free our Examiners from the important but non-mission critical paperwork associated with UR. That's where we worked with the folks at SMART-UR to come up with their Service Center idea. This process has moved the bar up even higher in our organization, which strives to achieve best practices in all areas. We believe in UR as a way to ensure effective healthcare delivery and reasonable costs. But, that requires constantly focusing on ways to improve effectiveness and efficiency throughout the system."

James Schlueter, President of J. A. Schlueter & Company (www.jaschlueter.com) the parent of SMART-UR, said "Our goal with SMART-UR is to maximize the value of UR and evidence-based medicine by allowing technology to optimize the application of the high-paid professional resources in the process of UR. By redirecting management focus from the mundane to the important issues - from clerical activities to medical management outcomes - we improve workflows, minimize delays and reduce operating costs."

Schlueter commented, "The Service Center is an extension of our commitment to find solutions to workflow bottlenecks. Eliminating workflow snags in the UR process is important because the best strategy in the world is only as good as its execution, and execution happens on the front-line."