Casenet, LLC, a leading provider of innovative healthcare management software products, today announced its release of TruCare 4.5. Release 4.5 builds on the foundation of TruCare's state-of-the-art functional architecture, to deliver increased authorization and claims payment accuracy, reduced Medicaid fraud and abuse, and enhanced Pervasive Population Management. This new TruCare release culls data from 140 key metrics to feed into its newest core module - Opportunity Identification.
Real-Time Authorization Web Services
The Real Time Authorization Outbound Interface (RTAOI) is available as an alternative to Casenet's high-speed 278 batch processing for outbound authorizations. The RTAOI allows for authorizations entered into TruCare to be sent real-time to the customers administrative system, including each line-Item request, for immediate validation. In turn, the TruCare Web service supports a real-time response from the administrative system, which enables the TruCare user to view the administrative systems authorization status while simultaneously processing the authorization in the TruCare Utilization Management subsystem.
This very sophisticated two-way real-time web service has been developed so that the administrative system interaction is generic and extensible, which enables it to operate with any administrative system.
Enhanced Medicaid and Dual Eligible Transportation Capabilities
TruCare Release 4.5s transportation functionality assists Medicaid plans with tracking the transportation benefit a benefit vulnerable to overuse or even fraud. TruCare enables a user to request, authorize, review, and monitor member requests for transportation services. This subsystem includes a flexible and easy-to-use recurring transportation authorization function, and a batch-process invoicing feature, which in turn allow more simplified billing for a plans transportation vendors.
Key Metrics
A standard set of 140 key metrics is provided in TruCare Release 4.5 with optimal ranges, filters, and units, to configure as appropriate. TruCare allows clinical users to record, view, and trend a member's laboratory results, immunizations, vital signs, and other clinical data. Release 4.5 performs automatic unit conversion and graphical displays of key metric data. In addition, all standard key metrics can be identified specifically as HEDIS measures for a member.
Opportunity Identification
TruCares Opportunity Identification functionality analyzes the broad spectrum of member data contained in the system, including:
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