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Health Records and Case Management

NCI’s health records and case management solutions—coupled with our innovative data mining and advanced analytics capabilities—detect fraud and abuse in healthcare service delivery and ultimately improve the healthcare system’s overall integrity.

For program and benefit integrity purposes, Federal agencies with entitlement programs need to collect, protect, analyze, and manage beneficiary information. Our team and our clients need access to beneficiary information to support analytics and investigations associated with program and benefit integrity initiatives. NCI AdvanceMed provides both health record management and case management solutions and has a secure storage facility used to receive, sort, and store medical records. The Medical Records Management Center team is bilingual and equipped with scanning, assembly, pre- and post-pay knowledge, and quality assurance skills. The Medical Records team also provides a customer service line, supports appeals and special projects, maintains a claims status website, and handles all mailroom activities. All medical record images are available from NCI AdvanceMed’s AdvanceTrack case management application. AdvanceTrack is a tailored web-based application that provides tools to support multiple benefit integrity lifecycle functions, including, but not limited, to the following:

  • Claims Data Import
  • Claims Assignment
  • Medical Record Management
  • Provider Contact Information
  • Medical Review
  • Inter-Reviewer Reliability
  • Report Center
  • Management Dashboards
  • Management Website
  • Benefit Integrity Case Tracking
  • Algorithm Tracking

Access to data and information necessary to make decisions is the core of AdvanceTrack’s primary business intelligence tool, which serves both staff and management teams alike. NCI AdvanceMed built the case management system with an emphasis on end-user self-service at one end of the spectrum and detailed real-time management dashboards at the other end.