ManageWare, LLC, a premier solutions company in the workers’ compensation industry, and Spear Technologies, Inc., the first and only insurance solutions provider to develop applications using the Microsoft Power Platform, announced a strategic relationship to develop real-time integration among the workers’ compensation claims and medical management processes. This type of connected process would significantly benefit workers’ comp claims organizations.
“This integration is the solution claims organizations need to get to the next level of savings and success,” said Chris Tran, CEO of ManageWare. “Our companies are able to offer this connectivity because we’re both on modern cloud platforms. We have in-depth workers’ comp experience coupled with an innovative mindset. This translates into knowing exactly where and how to deploy our technologies and AI capabilities to profoundly impact program performance.”
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“ManageWare forgoes point solutions – offering one comprehensive suite,” said Jose Tribuzio, CEO of Spear Technologies. “By facilitating this integration, we connect SpearClaims to the entire medical management process, our customers have complete claims and medical information. And in turn, ManageWare customers benefit from real-time claims data that can help drive and streamline the bill review and other medical management processes – creating even greater value, insights, and savings.”
Controlling costs has been a major imperative in workers’ comp, but an assortment of stakeholders, jurisdictional requirements, batch updates, and disconnected systems have made it difficult to achieve optimal savings. Instead, the result has been inefficiency, an incomplete picture of costs and outcomes, and an inability to proactively manage care for injured workers.
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“Disjointed processes and delayed data updates become a thing of the past, as our low-code / no-code claims system enables real-time API integration,” said Brian Mack, CRO at Spear Technologies. “Customers benefit from streamlined coordination of processes, including authorizations, utilization review, and prescription management. And injured workers receive more efficient care, so they can promptly recover and return to work.”
The integration will initially focus on three critical processes:
- Real-time integration. There will be an instant exchange of medical management and claims information, leading to streamlined financial reconciliation. Organizations will have an immediate and complete understanding of all claims and medical expenses, so they can grasp the full impact on their bottom line.
- AI-driven form recognition. Spear’s AI model will streamline the medical bill intake process. It learns where fields are on forms and automatically pulls data into the claims system. This data is shared with ManageWare, saving time in mailroom operations and data entry. This data might then initiate key medical management processes.
- Complete UR and bill review data. A common frustration is the inefficient exchange of information among claims, bill review, and utilization review. Now, information will be seamlessly shared between SpearClaims and ManageWare. As a result, staff will have all the information they need to make informed claims and medical decisions.
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