If you are involved with a Health Plan‚ TPA‚ PPO‚ or Long Term Care Provider and you are comparing managed care software plans, you will need dependable eligibility verification, referral management, capitation management, claims adjudication, and excellent reporting capabilities – at a minimum. Medical Case Management is most useful for a large medical provider, hospital, or other large clinical setting.
As a Medical Case Manager, you need to integrate patient administrative functions with regular accounting functions, medical billing, electronic medical records (EMR), among other functions.
Medical Case Management Software is like Medical Practice Management Software writ large, for the much larger organization, and thus must integrate with many of the other hospital clinical and management functions.
What are the features to look for in strong case management software?
One of the key decisions your facility may have to make is whether to look for web-based case management software, or whether your installation is better off with in-house customizable software. Even if your decision is to go with an installed system, you will need web interoperability with other institutions, clearinghouses, and patient interactive systems.
For comparisons of different medical case management software, download the free Medical Software Selection Kit.