Subrogation Claim Overpayment Recovery System (SCORS)
is a proprietary, next-generation business intelligence
software that streamlines the payment recovery process. It
represents a significant improvement in the management of
identification, settlement and adjudication. HCSG
interfaces seamlessly with its clients' claim management
systems and has the technical resources to support
efficient, secure implementation of claim data transfers.
In addition, HCSG has partnered with Symmetry® to
incorporate their Episode Treatment Groups® (ETGs)-based
methodology into HCSG's claims review and matching
application. The ETG system accurately assigns all
healthcare claims data, regardless of origin, into
episodes of care. HCSG's interest in adding ETGs was both
to assist its examiners in identifying any homogeneous
treatment patterns presented by a member and to confirm
from a clinical perspective that all treatments relevant
to the assigned injury classification are grouped and
included for review. YES, HCSG is HIPAA compliant.
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SCORS handles all identification, investigation, recovery and reporting |
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Comprehensive "data mining" routines which measure file quality and
recovery potential |
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Episode Treatment Groups (ETGs)-based methodology for matching
medical treatments to accident-related injuries |
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Automated outbound e-fax / email notification system |
To learn more about this valuable service, please contact: bbrumit@HCSG.net
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