Intelligent Software for Case Management and Utilization Review

DataCare helps workers’ compensation and managed care teams automate workflows, manage compliance, and organize complex medical records with AI — improving efficiency, visibility, and turnaround times.

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    20+ years supporting medical management teams

     

    3M+ utilization reviews supported

     

    150K+ case management cases supported

     

    SOC 2 certified and HIPAA compliant

    Why managed care teams struggle

    • Disconnected systems: CM, UR, claims, documents, billing, email, fax, portals, PDFs, and spreadsheets all create separate places for work to live.

    • Limited visibility: Supervisors struggle to see case status, deadlines, workloads, bottlenecks, and follow-up activity in real time.

    • Manual work: Documentation and review workflows slow down when they depend on repetitive steps and duplicate entry.

    • Compliance complexity: Regulated programs require consistent documentation, deadline tracking, audit trails, and jurisdiction-specific controls.

    • Claims-system gaps: Claims systems are essential, but they are not built for every specialized medical management workflow.

    One configurable platform for case management, utilization review, and medical workflow automation

    The DataCare Platform connects the workflows managed care teams rely on every day: case management, utilization review, AI-assisted document handling, reporting, and compliance tracking. Use individual modules where needed, or connect them into a broader operating system for regulated medical workflows.

    Case Management

    Manage referrals, documentation, reports, appointments, billing, and return-to-work workflows in one organized system.

    Utilization Review

    Track requests, deadlines, reviewer assignments, determinations, letters, and audit trails with configurable UR workflows.

    AI Document Assistant

    Use AI-assisted indexing, search, summaries, and document organization to reduce manual review time and prepare records for clinical and administrative workflows.

    Built for speed, visibility, compliance, and control

    • Automation — fewer clicks, faster case movement
      Cut routine work with rules-driven workflows (automatic letters, reminders, due-date logic, smart templates, billing rules).

    • Visibility — see work before it becomes a bottleneck
      Track case status, review timelines, workloads, turnaround times, and operational trends through dashboards and reports.

    • AI Document Assistant — turn complex records into usable information faster
      Auto-index and label documents, draft clinical summaries, and create billing entries; pull key facts to speed up documentation.
      Clients report significant reductions in indexing time (often ~50%) and faster review prep; results vary.

    • Compliance & Security — audit-ready by default
      SOC 2 + HIPAA controls, built to support URAC-accredited managed care programs, role-based access, and full audit trails keep PHI protected while documenting every action automatically.

    • Configurability & Scale — make it work the way your program works
      Customer and jurisdiction-specific letter templates, forms, and integrations (referrals, nurse notes, documents, billing feeds) let you standardize the platform while honoring each program’s rules.

    • Dedicated Implementation & Support — get a partner, not just software
      Work with a team that understands workers’ compensation, managed care, implementation complexity, and long-term support.

    Proven operational impact

    ↑ 20%

    Overall case manager efficiency improvement

    ↓ 19%

    Reduction in UR turnaround time

    ↑ 50%

    Indexing efficiency improvement

    ⏱ 5-min

    Average support ticket response time by a human

    ★ 9/10

    Customer satisfaction score

    Clients also report saving 1-2 hours per user per day in selected workflows, with some departments reporting substantially higher throughput after automation.

    * Results vary by client, workflow, implementation, case volume, and baseline process maturity. Efficiency, turnaround-time, and indexing metrics are based on selected client workflows.

    Built for complex managed care programs

    DataCare supports regulated medical workflows across workers’ compensation and healthcare programs, helping teams coordinate care, review treatment, manage records, and maintain audit-ready documentation.

    • Workers’ compensation
      Case management, utilization review, return-to-work, medical documentation, reporting, and compliance workflows across jurisdictions.

    • Health plan and payer medical management
      Support utilization management, care coordination, authorization workflows, document review, and clinical operations reporting.

    • Disability and return-to-work
      Track medical status, case activity, recovery milestones, communications, and return-to-work progress in one organized workflow.

    • Occupational health
      Coordinate employer-sponsored medical programs with structured documentation, task tracking, reporting, and secure access controls.

    • Auto and casualty medical programs
      Organize medical records, treatment review, documentation, and related claims workflows for no-fault auto and casualty programs.

    Trusted by managed care teams

    Michele Settel, President of Ascential Care Partners

    Craig Bates & Susan Kennon, Timberline Medical Consultants

    Thomas Kokkines, Vice President of Optimal Case Management

    Join managed care teams using DataCare to streamline case management, utilization review, and document workflows.

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