CareNet is a subscription-based Internet strategy for managed care communication and transaction processing.

CareNet provides a fully HIPAA-compliant Application Service Provider (ASP) model, which facilitates communication between gatekeepers of authorizations, remote medical offices where patient care is provided, the payer, oversight and accreditation agencies, law enforcement and prevention coordinators.

CareNet is the solution for Managed Care Organizations that want a tightly coupled solution with their providers, but where it is not practical to require the installation of software at the providers' facilities. CareNet solves this problem by allowing providers to access demographic, authorization and adjudication system, without installing any software at their end.

Beyond the features described below, CareNet is fast to implement and easy-to-use. Most implementations can be live within 60 days of contract signing.

Client Management
Client demographic information, insurance, financial status, eligibility, referrals, treatment episodes, and detailed claims history for each client under care is tracked. MCOs are able to exchange this information between themselves and providers seamlessly. Edit checks ensure data validity at the time of entry at the provider offices to reduce errors. The overall process minimizes paper-based communications, phone calls and fax expenses, and eliminating redundant data entry providing immediate ROI.

Authorization Tracking System
Allows MCOs to communicate electronically between the Access Center and their remote provider network. Users are able to exchange clinical data, eligibility information, and financial history in order to make educated decisions on patient care as well as reduce the turn-around time on referrals and authorizations.

Claims Processing
Integrated admission, authorization, and treatment data speeds the claims processes. Billing discrepancies are virtually eliminated and payments to providers are streamlined and accelerated because service delivery is tied to authorizations, admission dates, and other pre-defined criteria.

Generation and Submittal of Required State Reports
Netsmart takes the responsibility on behalf of its CareNet clients for the implementation of the business rules per each States specifications, and the generation and submittal of the required State Reports.

CareNet:

• Puts valuable data in the hands of the people who make critical care decisions. Providers share access to the complete patient history, including case notes, admissions data, a communication dialogue and the total dollars spent on this client across the region.
• Gives greater control over who receives services, and over each dollar spent, by providing timeframes for service delivery, limits on admissions and referrals and budget overage notification flags.
  

ASP Approach
With the ASP approach, the entire system - software, database, and infrastructure reside at a central data center facility. The provider no longer has to worry about hardware and software upgrades and their associated costs.

For each HMO or MCO client, a private portal site is established where their member providers and partnering agencies can login via the Internet to complete their virtual paperwork, necessary reporting, and access to client information to make better informed decisions all in a HIPAA-compliant fashion.

Contact us today for additional product information.