IME Claim / Case Management and Billing Software

Comprehensive and easy to use claim/case data recording, note taking, T+E / flat rate / flat fee/cost plus based billing, report production, document sharing on claims, document library for (procedures, instructions, document delivery), calendar workflow management.

Secure Document creation (reports, letters, etc.), upload and retrieval over the web or on your local network.

Secure online access to claim/case data (case details, notes, appointments, work performed, etc.) and associated documents (reports, pictures, etc.) for your medical specialists and your clients.

Integration with LEDES electronic billing submission systems (i.e. Allegient Systems, Xchanging).

Here is some of what W5 can do.

Create, store, search, protect claim/case data Claimant/examinee name, address, contact, injury information Attorney name, address, contact details Adjuster name, address, contact details Provider name, address, locations, speciality information Define services and case types Schedule and manage one or more services (examinations,reviews,etc.) per case Powerful and easy to use searching

o Use search results to print reports and labels o Use search results to remember a list of files for later recall o Use search results to create Excel spreadsheets

Record and search case notes and service notes Powerful and easy to use document management

o Create documents (letters, notifications, reports, etc.) using W5 templates o Document Library for procedures, instructions, manuals, etc o Upload/download documents, images, faxes, evaluation files, etc.

Manage your fee schedules and your provider rate schedules in multiple currencies Schedule, reschedule, monitor and report examinee appointments with providers Task and appointment diaries User calendars Invoices in multiple currencies Secure W5 features and data with user and claim/case access rights Manage multiple branch locations including inter-branch claim/case sharing and

transfers Improve efficiency, simplify communication, reduce costs Bring clients online to submit case referrals and electronic documents, review and

monitor case status, make notes and provide instructions, access/download reports Bring providers online to submit reports, images, notes and bills Email

o Send and receive emails o Save Emails directly onto the claim/case o Save Email attachments as documents on the claim/case

Secured data exchange via W5s Workflow Manager service including offline T+E and notes, invoice payments.

Automated currency exchange rate updates LEDES 2000 bill submission Integrate with accounting systems such as Intuit QuickBooks, Peachtree and Microsoft

Great Plains

Some of the above features are add-on modules.

Billing & Invoicing Claims can be billed at regular intervals, on demand or just at closing. You can tell W5 what the regular interval is and W5 will let you know when to bill each

claim. The interval can be changed for any claim at any time. Billing for any claim can be set to “final bill only” and/or can be postponed indefinitely. Fees and expenses are automatically gathered and can be changed as required. Any expense can be automatically billed through automatic billing using any of several

very powerful and flexible commands. Flat Fees can be set for any claim or any individual invoice. Invoice detail formats can be defined by the user. Subscription claims are automatically prorated and a separate invoice is created for

each Insurer. Last billed dates are automatically updated. Accounts receivable and General Ledger postings are automatically created and are

passed into your Accounting system on demand. All claims which are overdue for billing are listed for investigation.

Check System Base check anounts on available reserves. Make instant reserve adjustments where authorized, Produce audited payment transactions that are automatically reflected in the financial

values, Multiple bank accounts and check formats, Check register and transaction audits, Reconciliation, Create check requests for delivery to external processes such as insurer claim

departments for approval and issuance, Set up request approval workflow.

Claim Search By Insurer By Insurer claim reference By Examiner name By Billable Resource By Insured name By Policy reference By "Other" Party By File Group By Claim Title By Third Party name By Third Party reference By Date of Loss By Received Date By File Reference By Address information By Note text By Reserve transaction dates By Any Name listed on a file ... plus many more search combinations

  Diary & Calendar System The W5 diary is an easy to use appointment and task management system. W5 users can maintain appointments, tasks, and record other important deadlines and

reminders. Each entry can be set for any date/time. Events that recur on a regular schedule can be automatically rescheduled for the next

date by the diary system. As a user manages their diary entries the diary can be used to assist in time and

expense recording. Since diary entries can reference claims, the diary system can present a diary for any

claim, providing the users with a claim specific schedule of tasks and appointments.

Example: Claims are entered into the W5 database as they come into the office. As a claim is entered it may or may not be assigned to an billable resource. However, it does need to be reviewed by someone so a “review new claim” task referencing the new claim is entered into the appropriate persons diary. The reviewer opens the claim information from the diary, reviews the available data and assigns the claim to the appropriate billable resource via the “new claim” diary notification task. The reviewer closes the diary entry and if appropriate, records their time spent on the file. The billable resource who is now assigned to the claim will be notified in their diary that they have a new claim.  

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Document ManagementW5 Document Management Features

Securely create, send and retrieve documents whether you are on the web or on your internal network.

Create documents (letters, faxes, reports, forms, etc.) from templates with automatic data fill-in directly from the claim.

Upload documents directly to the claim o From scanner, o From email attachments, o Estimate files, o Excel worksheets, PDF files, faxes, word documents and more.

Share documents among claim files having the same policy number or client claim number.

Attach documents directly from the W5 document library repository so that you dont need unnecessary multiple copies of any document.

Add common claim documents into the W5 document library repository. Review and / or revise documents attached to claims. Send documents as email attachments. Send a document link that will download the document when the recipient clicks on it.

Our "send it and forget it" technology takes the pain out of sending large documents or many documents when you are working on a slow or intermittent Internet connection whether you are working from home or from a hotel. This is the same technology that helps make our Document Scanning module work so well under high demand workloads.

The W5 Document Library Repository is an extension of our Document Management system.

The library allows you to collect and organize documents such as: Procedure manuals, Policy wordings,

Standard forms, Expense worksheets, Client specific handling instructions, Special forms, Client Loss Reports for distribution, Government reports, Etc.

The documents in the library can be secured so that users can view and / or contribute to document groups as defined by their users security clearances.

Depending on the availability settings: Library documents can be attached to any claim as a "virtual copy" so that the

document resides in the library but can be directly reviewed from the claim. Library documents can be copied as a new document to any claim and used as a

template.

 Document Scanning Scan single page or multiple pages from one or more documents to compose a single

document in W5, Crop, rotate and move pages within the scanned document, Use a multi-page sheet feeder, Control colour and image quality settings, Instant load into W5 or queue for batch or after hours transfer to the W5 document

server.

 PowerClaim XML Estimate filesW5 Document Management service can now create PowerClaim XML estimate files from W5 claim data. Using W5 templates, users can export data from W5 directly into an XML file that PowerClaim can process. This means that PowerClaim users can exchange data with the most comprehensive, flexible and easy to use claims management and adjusting system on the market today.

Imagine being able exchange data between W5 and PowerClaim simply by selecting the "PowerClaim Estimate" template from the new documents list. You can even create your own PowerClaim templates to handle different requirements for different types of estimates.

W5 doesn't just create a PowerClaim XML file. That estimate can now be managed, shared, distributed and updated safely and securely by the W5 Document Management service.

All of your estimates are now securely available to whomever you grant access - anytime, anywhere.

This is one of the "easy to use" goals that W5 is all about: Record once - Use everywhere

Integrated E-Mail Manage your email from within W5. Send and receive emails. Organize emails and attachments. Attach emails to claims files. Instantly convert email attachments into documents attached to a claim file.

Ledes Support Create LEDES e-billing transmission files on demand, Current LEDES 2K format, Flexible task and activity mapping as required by clients for Allegient Systems,

Xchanging, etc

Reserves Maintenance Record coverage limit, coinsurance, valuation type, etc. Record financial transactions in multiple currencies such as set/adjust reserve,

payment, recovery, set/adjust deductible, apply deductible. Enforce financial rules. Define reserve methodologies to accommodate strict or loose enforcement for

different client requirements. Produce reserve worksheets complete with financial audit trail Monitor aggregates Issue payment requests and write checks

 

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