Care Management Software Solutions


TCS Healthcare Technologies understands that using manual processes or multiple systems to support managed care workflows is frustrating and inefficient. The ACUITY Advanced Care suite of products offers automated, intuitive, efficient products designed to streamline and automate workflows and manage processes, making your programs and team more effective, efficient, and productive.

Some of the challenging operational areas that our software can

help solve for your organization


Utilization Management

  • Prior Authorization
  • Admission Review
  • Concurrent Review
  • Retrospective Review
  • Criteria Application
  • Evidence-Based Guideline Application
  • Medical Review
  • Peer-to-Peer Review
  • Grievances
  • Reconsiderations and Appeals
  • Standard and ad-hoc reporting
  • Turnaround-time tracking and reporting
  • Web-based provider portal for authorization submissions
  • Real-time automated authorization approvals

Referrals

  • Notification
  • Specialty Referrals
  • Benefit Carve-outs
  • Network Management
  • Metrics Reporting

Case Management

  • Stratification/Identification
  • Automated enrollment, task creation, and letter generation
  • Screening Tools
  • Assessment Tools, including branching logic and scoring
  • Care Plans
  • Short-term, transactional programs
  • Long-term case management programs
  • Multi-disciplinary team management
  • Care collaboration
  • Patient communication and education
  • Metrics Reporting
  • Clinical Outcomes Measurement
  • Transition of Care Programs
  • Program Measurement

Disease Management

  • Stratification/Identification
  • Automated enrollment, task creation, and letter generation
  • Screening Tools
  • Assessment Tools
  • Care Plans
  • Short-term, transactional programs
  • Long-term case management programs
  • Multi-disciplinary team management
  • Care collaboration management
  • Patient communication and education
  • Metrics Reporting
  • Clinical Outcomes Measurement
  • Program Measurement

Population Health Management

  • Stratification/Identification
  • Automated enrollments, task creation, and letter generation
  • Gaps in Care Mining
  • Assessments and Care Plans for
    • – Physical activity and general fitness
    • – Nutrition and diet
    • – Depression & substance abuse
    • – Weight control
    • – Smoking cessation

Quality Improvement

  • Quality of Care Case Review
  • Reconsiderations and Appeals
  • Grievances
  • Program and Staff Auditing
  • Peer Review Programs
  • Satisfaction Programs
  • Patient and Program Outcome Review
  • Metrics Reporting