Technology Solutions

Innovation at Work
ExamWorks Clinical Solutions (ECS) develops proprietary software and IT platforms that deliver real-world solutions for our clients.

Galileo is an integrated Mandatory Insurer Reporting (MIR) and Medicare Secondary Payer (MSP) compliance solution. CaseWorks™, our medical management software, provides staff and clients with a state-of-the-art, easily accessible, reporting, and communication tool.

Galileo and CaseWorks™ help business managers streamline workflow processes and realize the best possible outcomes.

CASEWORKS™

CaseWorks™ and its applications are an integrated platform offering an efficient, proactive solution to address the challenges facing an injured worker. CaseWorks™ ensures case managers, quality control, billing and account executives are working effectively and productively. This dynamic platform delivers the ability to make current or future adjustments to improve performance standards.

expand

The CaseWorks™ platform allows employers, employees and all claims professionals an organized approach to managing the medical well-being of an injured worker, while expediting maximum medical improvement and delivering an expedited return to work. Utilizing CaseWorks™ either as a standalone tool or integrated into your current claims system can translate into substantial savings for your organization, while offering a true medical recovery solution.

CaseWorks™ is an integrated platform that:

  • Offers an efficient proactive solution to address the challenges that a Workers’ Compensation injured worker faces today.
  • Ensures case managers, quality control, billing, and Account Executives are working effectively and productively.
  • Creates the ability to make current or future adjustments to improve performance standards.

Galileo

Galileo is an innovative solution that integrates Medicare Secondary Payer (MSP) and Mandatory Insurer Reporting (MIR) requirements to satisfy all aspects of Medicare compliance.  Using MIR data to identify claims with MSP exposure, conditional payments and allocations protects clients from potential fines, penalties and litigation post-CMS reporting.  

expand

Our Galileo platform includes:

MIR Reporting Service

  • Simple, intuitive web portal to provide MIR claims data
  • Secure file exchanges via SFTP
  • Unmatched CMS acceptance
  • Dedicated technical and compliance support

Medicare Secondary Payer Program

  • MSP analysis and forecasting
  • MSP compliance services (conditional payment, MSAs, CMS submission)

Integrated MSP Compliance Solution

  • Integrated MSP outcomes
  • Claims benchmarking
  • Data analytics to support underwriting and claims decision-making

Business Intelligence

ExamWorks Clinical Solutions’ Galileo business intelligence portal allows ECS to create reports that measure clients' compliance rates and assist in client stewardship activities.

expand

ExamWorks Clinical Solutions continues to search for opportunities to utilize data to enhance our clients’ compliance programs and outcomes. As an evolution of our MIR reporting capabilities, we are developing an advanced business intelligence platform specific to Medicare Compliance issues.

Key features of our interactive web portal for access to all MIR reporting data will include:

  • MIR Performance and Compliance rates
  • Breakdown of TPOC amounts by line of business, ICD codes, goegraphic region
  • Trending of data by jurisdiction and claims office
  • Ability to proactively rate claims handling practices