SmartSimple CMS360 is a accident benefit claims and referral management solution for medical insurance businesses, designed to bridge the gap between insurers, health care providers, and independent medical examiners. The platform provides features for medical case management, employment services, community care cases, structured settlement cases, and more. The SmartSimple CMS360 platform allows insurers to manage their cases, request evaluations from health care providers, arrange appointments, share data, create invoices, and more.
To aid with managing medical cases, SmartSimple CMS360 provides insurers with a 360 degree view of their pending claims within a personal list view of their cases and tasks to be completed. Claim information is provided such as the claimant, claim number, date of loss, status, and profit centre, and summary files provide additional information on aspects such as the policy type, legal details, attached files injury details, services required, and any notes or comments on the accident. Claims can be viewed within the calendar in order to gain an overview of any scheduled appointments or activities relating to that claim, and insurers can add new appointments with health care providers or medical examiners to aid with the claim.
SmartSimple CMS360 also facilitates the management of attendance and disabilities with tools for tracking employee disability claims within places of work. Claims of short and long term disabilities can be handled, users can schedule ‘return to work’ activities, and appointments and treatments can be booked with service providers internally, or externally. The platform also provides the tools to manage career counseling, employment assistance, community care, and structure settlements with claimants, annuity, life, and casualty companies.
Software by SmartSimple Softwarewww.smartsimple.com