Chicago, IL – June 19, 2018 – Rising Medical Solutions, a longtime MCG Health Company partner, is now rolling out MCG’s powerful Official Disability Guidelines™ (ODG) analytics directly to customer users. Rising’s latest enhancement to its client web portal, VISION™, provides users with single sign-on access to ODG’s robust claims scoring capabilities, enabling claims professionals to more accurately and efficiently evaluate, mitigate, and manage risk.
Augmenting Rising’s internal practice of applying ODG and other evidence-based methodologies to deliver its managed care programs, customers are now able to see automatically and firsthand how their claims scores change based on the ongoing clinical information Rising parses from medical billings.
With Rising’s ODG system updates and real-time results retrieval, adjusters can leverage ODG predictive analytics to identify potentially high severity claims, prompting early interventions. Rising’s clients can also use ODG return-to-work projections to establish reasonable target dates for injured employees to resume workplace activity. Access to ODG reserve projections improves claim outcomes by effectively forecasting medical, indemnity, and administrative costs, in addition to determining if reserves are too high or too low.
“Increasingly customers are looking for Rising to become their ‘technology hub’ for accessing various automations, tools, and integration partners from a single source,” says Rising Chief Operating Officer David Huth. “Such efficiencies reduce the number of resource-intensive integrations our customers need to perform, as well as the number of systems adjusters need to access in order to manage each claim.”
Another integration advantage is Rising’s custom ODG dashboards, which improve claims monitoring and accelerate user action. In VISION™, adjusters can access aggregated views and drill into their open claims in each ODG risk category, while supervisors are alerted to all high-risk claims for each adjuster under their management. The dashboards also display the difference between current reserves and ODG’s projected costs for each risk category, allowing for any quick, necessary adjustments.
“Since Rising’s medical bill review, diagnosis, and treatment data is often the backbone of our customers’ care management decisions, it is a natural evolution in our value chain to extend the decision support tools and ‘one-stop’ capabilities we provide customers,” says Huth.
On average, Rising releases one major enhancement to its VISION™ technology hub per month. Near-term releases include provider scoring enhancements and additional integrations with ancillary medical management partners.
About Rising Medical Solutions
Rising Medical Solutions is a national medical-financial solutions firm that provides medical cost containment and medical care management services to the workers’ compensation, auto, liability and group health markets. Rising also directs and publishes the annual Workers’ Compensation Benchmarking Study, a national research program examining the complex forces impacting claims management in workers’ compensation today.
ODG, an MCG Health company, provides unbiased, evidence-based guidelines that unite payers, providers, and employers in the effort to confidently and effectively return employees to health. The clinical guidelines and analytical tools within ODG are designed to improve and benchmark return-to-work performance, facilitate quality care while limiting inappropriate utilization, assess claim risk for interventional triage, and set reserves based on industry data.