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.

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