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Concentra Linkages

Clinic Integration

Innovation First Notice has established a link with Concentra’s Patient Management System. Whenever a new patient is entered into the Concentra system at one of its clinics, an email notification is sent to the ClaimCapture system. One of our call reps then makes an outbound phone call to the Supervisor or Risk Manager. If appropriate, a new FNOL is entered into ClaimCapture based on the information provided in the call. Distributions are then sent out, as always, based on a client’s business rules. This integration significantly reduces reporting lag time from an average of 8-10 days down to 2 days.

PPO Pathing/Telephonic Panel Postings

ClaimCapture has access to Concentra’s FOCUS Network, a list of medical providers and Concentra clinics that can be searched by geographic location and/or medical specialty. Typically, this is used during the claim filing process to give callers the name and number of a local medical provider. This link can also be used for standalone referrals, when a user is calling for the sole purpose of finding a doctor and doesn’t need to file a claim.

Telephonic Case Management

Telephonic Case Management (TCM) is a unit of Concentra that focuses on managing medical cases, with the primary goals being to speed up the return-to-work process and better control the costs associated with a claim. Claims taken by Innovation First Notice are forwarded to Concentra personnel via fax or email for review. Based on the specifics of a claim, the case may be assigned to TCM or to a sister unit, Field Case Management (FCM). FCM has a similar focus as TCM, but differs in that it actually visits patients rather than managing the case over the phone.

Bill Review

Using highly sophisticated software systems and technically proficient medical review staff, Concentra’s Provider Bill Review delivers one of the most comprehensive reviews available in the market today. In an industry where medical claims costs continue to grow at an alarming rate, Provider Bill Review is uniquely designed to achieve savings on virtually any type of medical bill not only through fee schedule and usual and customary reviews, but also by incorporating discounts through its own network and out-of-network offerings. Clients use bill review results for proactive management of medical care and claims administration in the workers' compensation and auto industries. Innovation First Notice has established integrated data exchange with Concentra’s bill review services whereby key loss information is automatically entered in the bill review platform. This linkage reduces errors and cycle time and can be augmented with custom questions and pathing rules in ClaimCapture.