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AddOntellus™ ClaimCenter Integration

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Did You Know?

Ontellus Is The Nation's Largest, Full-Service Procurer Of Records...

 

  • Medical Records
  • Wage & Employment Records
  • Diagnostic Imaging Files
  • Pharma Records
  • Social Security Records
  • Billing Records
  • Other Claims-Related Data Services

 

Ontellus enables claims adjusters with analytics that help review case records in a logical timeline that dynamically adapts as more records are retrieved. Adjusters can share important sensitive HIPAA data digitally in the cloud with their legal counsel to support litigated claims.

Insurance claims adjusters and regional CLCs using Guidewire ClaimCenter™ order their claims records from Ontellus™ via the My.Ontellus.com™ web-based cloud portal.

This typically involves logging in and re-keying the claims data stored in ClaimCenter. Additionally, the external portal is used to check the status of records and for viewing the retrieved records. This results in adjusters jumping from one application to another, impacting response time and productivity.

AddOntellus™ allows claims adjusters to securely order records from Ontellus within ClaimCenter™. This single-sign-on integration alleviates the extra steps of leaving the ClaimCenter™ environment and re-entering order details, such as claimant name, d/o/b, SSN, claim number and billing information.

After placing the order, adjusters can monitor the status of the request, take action upon it if needed (such as custodian fee approvals) and view/download the medical records without leaving ClaimCenter™. Records delivered to claims staff are securely passed to ensure all data privacy and security controls are met.

The AddOntellus™ add-on seamlessly integrates Guidewire ClaimCenter™ and the My.Ontellus™ API to support a records retrieval process from within ClaimCenter.

AddOntellus-Guidewire@2x
  • Single Sign-On: Claims staff can securely order from within ClaimCenter™. Seamless to Ontellus services, removes rekeying for orders, Open API
  • Order, Status, Receipt of order details from inside ClaimCenter™
  • Records Delivered to Claims Staff: encrypted records to be securly passed from Ontellus to CalimCenter™ for viewing/downloading

From Within ClaimCenter, The Claims Adjuster Can

  • Initiate a records retrieval request by selecting “Records Retrieval –Ontellus” from the ClaimCenter Service Screen
  • Perform a Provider Location Search of the Ontellus facilities database: A Facility can be searched for by name, address, phone, zip
  • The Location specific details are auto-filled upon selection of the location from the facility dropdown
  • Submit the Ontellus Record Request with Claimant & Location specific information and upload a signed HIPAA Authorization/Legal document
  • The Name, DOB, SSN & Claim Number are auto-filled from ClaimCenter
  • Track all details related to the submitted order via the Ontellus sub-tab within the Service screen
  • >Provide fee approval and updated legal/authorization documents from within ClaimCenter
  • Review and download records from within ClaimCenter when records are obtained via a link to the records in ClaimCenter

Primary Benefits

  • Prefilled claims information while ordering, eliminating the need to rekey information
  • Orders records quickly and accurately passed to Ontellus
  • Automated status updates
  • Secure delivery of records retrieved
  • Enables all record related approval activities to be performed in ClaimCenter
  • Instant access of information

Seamless ordering, statusing, and viewing/downloading medical, billing, and other necessary records to evaluate claims from within ClaimCenter, saves time, improves adjuster productivity, and reduces cost.

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