Experience SmartCare™ for MCOs
Benefits of SmartCare™ for your MCO (Managed Care Organization)
SmartCare™ MCO is designed to help Managed Care Organizations manage, communicate, collaborate with, and pay their external service providers. This managed care organization software goes beyond just tracking and coordinating services among providers and enables organizations to provide a more holistic collective care plan.
- Easily manage providers, including contracts and rates, credentialing, site review, and provider search for member referrals.
- Process claims from the provider network, including receiving 837 electronic claims; adjudication processing; and payment, check processing, and RA, and 835 distribution.
- Easily manage client information, including current medical and billing status, an overview of all claims by current status, and scheduled events (hospitalizations, discharges, etc.)
- Track and report on key metrics, including authorization tracking, hospitalization pre-screens, hospitalization concurrent reviews, and hospitalization discharges.
- Manage capitated arrangements, including documentation of UM review of authorizations, justification for approved services that meet URAC standards, and alerts and messages for important events such as when a provider’s contract reaches its cap.
- Provide treatment based on evidence-based principles through performance measurements and standards of care.
- Manage patient population levels of care and create recommended service packages based on patient level of care.
SmartCare’s robust functionality is ideal for Managed Care Organizations
SmartCare™ MCO is the only application on the market that goes beyond just tracking and coordinating services among providers. It enables Managed Care Organizations to effectively leverage provider data in real-time. SmartCare™ MCO enables organizations to easily manage client information to provide a more holistic collective care plan while also helping to reduce provider frustrations.
SmartCare™ MCO’s integrated functionality enables Managed Care Organizations to manage, communicate, collaborate with, and pay their external service providers. It enables these same providers to provide treatment based on evidence-based principles through performance measurements and standards of care. SmartCare™ MCO provides the robust functionality managed care organizations need to manage, communicate, collaborate with, and pay their external service providers and reduce overall provider abrasions.
Designed to help behavioral health organizations succeed
Hosted on the stable, secure Microsoft Azure cloud, SmartCare is the one platform that eliminates the need to connect, maintain, and secure disparate systems.
SmartCare supports an extensive suite of solutions tailored to specific areas of a practice—from primary care to business intelligence—all aligned on one platform for holistic care management.
As a true enterprise platform, SmartCare is ideal for multi-faceted organizations who provide many types of behavioral health and human services.
Our in-house implementation services and Customer Success Program ensure that all of our customer partners use the SmartCare platform’s powerful functionality to reach their full potential.