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Case Management

Ensure efficient and consistent case handling.

Investigators are on the case with this management module inside HMS® Fraud Solutions. Manage cases easily with this integrated platform that pairs data and investigation workflow. An easy-to-read management dashboard displays critical information all in one place.

Eliminate your spreadsheets and databases.

HMS’s Case Management replaces the need to manage multiple documentation stores. It provides a comprehensive case tracking system that allows your fraud investigators to effectively manage caseloads.

The module serves as both a workflow-management technology and a repository of medical records, investigator notes, case findings, and other documents – all while automatically pulling in case subject and claims data from your underlying data files, eliminating repetitive data entry.

Imagine a tool that:

  • Documents case materials, including all activity and findings
  • Provides a platform to manage workflows for staff, ensuring that all cases are handled consistently and according to established standards
  • Supports quality control activities through easy access of case activities and turnaround times
  • Includes imported data entry functionality
  • Imports any digital file via notes and attachments
  • Delivers infinite storage
  • Includes regulatory-required and management reports

Since Case Management integrates with all of our PI Portal modules, you can initiate a case at any point during your targeting, whether from a Provider Profile, Lead Management, or Guided Analytic output. Standard and customized workflows and case-dependent tasks build in a quality assurance process matching your policy requirements.

As a result, you get easy monitoring of key performance indicators, an ongoing chronology of cases, and a simplified record of claim-level findings and savings. This integrated module even provides return on investment figures.

HMS’s Case Management module provides a means to manage cases effectively, maximizing the value of your investigations unit.

Fill out the Contact form to learn more about Case Management.