HEALTHsuite®
Utilization / Authorizations Management Module
A key aspect of managing health care is the ability to properly authorize and monitor utilization of medical services. Through the Authorizations / Utilization Management module, health care organizations can completely automate the process of authorizations and referrals, thus eliminating the manual effort and ensuring accuracy. In addition, the system supports the entire utilization review process. Embedded clinical criteria and access to complete member history provide the foundation for accurate medical management. HEALTHsuite captures service information in English, and converts them into standard ICD-9, ICD-10, CPT-4, HCPCs coding formats for matching claim processing. Workflow features automate the entire review process, thus eliminating manual effort and ensuring accuracy. HEALTHsuite claims processing software supports unlimited comments with the ability to protect medical comments from view of unauthorized users. Time-saving features, such as the ability to copy services and extensive search capabilities that allow full-text descriptions or code values to be used, reduce user effort and administrative costs.
Return to Claims Processing Software - HEALTHsuite®
All contents ©2008, RAM Technologies, Inc. All rights reserved. Information in this web site is subject to change without notice. RAM Technologies makes no guarantee and has no liability for incorrect or outdated information contained in this site. HEALTHsuite is a registered trademark and eHealthsuite is a trademark of RAM Technologies, Inc. IBM is a registered trademark of International Business Machines Corporation. All other brand and product names are trademarks or registered trademarks of their respective companies. The Utilization Management Software and Authorization Management Solutions of RAM Technologies have been successfully implemented at health plans and benefit administration companies throughout North America and offer the best value among all health care payer / payor solutions available today.
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