In the conclusion of our three-part series, ISG explores the importance of technology and administrative support when it comes to choosing an IME partner. In part one, we explored provider network management and addressed whether size of the network matters and the importance of IME report quality. In part two, we addressed why it’s important to work with an IME partner that has well established processes for appointment scheduling and reminders to minimize patient no-shows.
Part 3: Customer Support – Technology and Administrative Support
The true testament of any IME company is how well it supports its customers – from initial receipt of the referral to report delivery and claim closure. It’s important that your IME partner has both the flexibility to support any unique requirements you may have and the right technology to make program management easier and more efficient for busy claims professionals.
Technology has transformed every aspect of the claims process, including IME management. The ease and security of transferring information in real-time has decreased turnaround times and facilitated a more efficient way to transfer data while protecting health information. As medical records containing sensitive HIPAA information is exchanged as part of an IME, make sure that the company you are working with has tight security controls, including SOC compliance. At ISG, our systems are routinely tested and audited by internal and external auditors to provide clients assurance of our secure data management practices. We also provide a secure self-service platform that allows referrals to be submitted and managed online.
While it’s beneficial to have a portal for clients to use, it’s even better if your IME partner’s technology is integrated directly with your claims system to create an even more seamless and efficient process.
The ISG technology platform, which has served as an accelerator to support clients in achieving optimal results, is integrated with many commercial and proprietary claims systems. As part of a new integration process, we do the heavy lifting to map our system to our client’s claims system. Once established, the integration allows claims professionals to manage IMEs without ever leaving their own system. For example, an integration allows initial referrals to be submitted, and records and reports to be transferred between the claims system and ISG without the claims professional ever having to open an email or a separate portal. This is the most efficient management process that not only improves turnaround times but minimizes errors.
Technology can also be used to support record retrieval and organization. It’s essential that the IME physician receives all medical records and that they are organized properly. For claims professionals, gathering records can take time. ISG offers a record retrieval solution that manages the process of requesting and receiving records from medical providers. We use technology and nurse reviewers to organize all records and put them in chronological order so that the packet provided to the reviewing physician is comprehensive and easy to read. Streamlining the records management and distribution program drives further efficiency gains, cycle time improvements and cost benefits.
Finally, when selecting companies to serve on your company’s IME panel, it’s important to understand each company’s ownership structure. Through acquisitions, many companies share the same parent company but retain their individual brand that obscures their ownership structure. It’s a good idea to evaluate corporate structures to ensure diversity on your panel.
Key questions you should ask when evaluating an IME partner include:
- What security controls are in place to protect health data?
- Do you have SOC and URAC certifications?
- Does your system integrate directly with claims systems?
- Do you offer record retrieval services?
- What is your corporate ownership structure and what other subsidiaries in your organization provide IME services?
IMEs can have a big impact on claim outcomes, so it’s important to work with the right IME partner. We hope you enjoyed our three-part series. If you would like to work with us, contact customerservice@isgvalue.com to get started.