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AmeriChoice Inks Deal With MEDecision.

Business Editors/High-Tech Writers

WAYNE, Pa.--(BUSINESS WIRE)--Sept. 15, 2003

MEDecision to Provide Transactioning and Automated

Authorizations Segment of its Integrated Medical

Management Suite of Software Solutions and Services

MEDecision, Inc, a software and services leader in care management, today announced that AmeriChoice, the public sector health care unit of UnitedHealth Group, has expanded its Integrated Medical Management (IMM) implementation to include Transactioning and Automated Authorizations. A MEDecision client since 1998, AmeriChoice is one of the country's largest providers of Medicaid and government health care programs, with more than 1.2 million members nationwide.

MEDecision's Transactioning and Automated Authorizations capability electronically links physicians and hospitals with managed care organizations (MCOs) to support the direct submission and processing of a variety of care-related transactions, including referrals, authorizations and extensions. The software solution provides multiple communication sources, including the Internet, telephone-based interactive voice response (IVR) and electronic data interchange (EDI). Transactioning and Automated Authorizations is one component under MEDecision's Integrated Medical Management umbrella of software and services.

"By offering multiple means for communication, all components of our network, from the largest hospital system to single physician offices can share the benefits of a streamlined referral and authorization process," said Bill Hagan, AmeriChoice senior vice president, information and technology. "This heightened efficiency offered by this solution will increase the quality and speed in which care can be delivered, without sacrificing information or data quality."

"We are pleased to be able to expand our relationship with AmeriChoice and our support and service in helping them deliver the highest quality of care possible," said chairman and CEO of MEDecision, David St.Clair.

MEDecision's Transactioning and Automated Authorizations software helps MCOs increase efficiency by combining the organization's business and clinical policies with clinical content creating a standardized set of business rules usable by the entire organization. The application of those rules against submitted requests then allows MCOs to automatically approve a majority of requests from physicians and hospitals.

"We have seen MCOs using Internet and IVR communication paths that have been able to automate and approve up to 80 percent of their referral requests," continued St.Clair. "The automatic approval of routine requests allows requests to be initiated, processed and completed without human intervention. Just as important, the administrative relief allows care managers to concentrate on providing better care to members, focusing on improving outcomes."

About Integrated Medical Management

Integrated Medical Management (IMM) is both a vision and product solution born out of the healthcare industry's need to unite disparate, best-of-breed care management systems into a single, holistic solution. The goal: 1) handle information more efficiently, and apply rules more consistently throughout the medical management decision-making process, and 2) recognize and leverage the interdependencies of care management, analytics, and transaction/authorization systems. The result is higher quality of healthcare lower costs.

MEDecision's IMM software platform fuses best-of-breed applications in Analytics and Disease Management, Advanced Medical Management, and Transactioning and Automated Authorizations. MCOs use the resulting solution to identify high-risk, high-cost members, diseases and conditions, which then automatically feed the programs needed to improve patient care and optimize costs. Further, MEDecision's IMM automates healthcare transactions between MCOs and providers, thereby allowing the automated systems to focus on costs and allowing the professionals to focus on outcomes, while driving a consistent clinical philosophy throughout the care management process.

About AmeriChoice

AmeriChoice facilitates the delivery of health care services for more than 1.2 million beneficiaries of public sector health care programs such as Medicaid, Child Health Insurance Programs and state programs for the uninsured in 13 states. AmeriChoice combines community-based networks with preventative services, outreach and intensive case management to serve the complex and unique needs of individuals in these programs.

About MEDecision

MEDecision is a leading software and services provider of integrated care management solutions. Founded in 1988, the company specializes in linking patients, providers and payers in an information network to improve overall health outcomes and reduce costs. MEDecision's software products are being used by more than 50 managed care organizations to improve the quality of healthcare and reduce both administrative and unnecessary clinical costs for approximately one in every seven Americans with health insurance. For more information about MEDecision and Integrated Medical Management, please call 610-254-0202, email Marketing@MEDecision.com or visit www.MEDecision.com.

MEDecision is a trademark of MEDecision, Inc. The MEDecision logo and product names are also trademarks or registered trademarks of MEDecision, Inc. Other products and brand names are trademarks of their respective owners.
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Publication:Business Wire
Geographic Code:1USA
Date:Sep 15, 2003
Words:744
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