TCS Healthcare

TCS Healthcare Technologies is a leading provider of software and clinical solutions that improve medical management (UM/CM/DM) performance and effectiveness for health plans, insurers, providers, third party administrators, medical management companies, and others, who serve the private and public sectors.  For more information about TCS, call (800) 236-7190 or visit the TCS Healthcare website.

ACUITY Functional Overview

The ACUITYAdvanced Care Management System is an integrated, user-friendly medical management software application that enables our clients the flexibility to implement a system that will meet their specific needs for case, disease, wellness, and utilization management. The following is an overview of the functionality in ACUITY.

ACUITY is a "patient centric" system that provides the ability to maintain:

• Member information – including demographic and eligibility data
• Provider information – including demographic, specialty, and network data
• Plan information
• Employer information

The ACUITY Care Management Module is used for case, disease, and wellness management and provides the ability to:

• Identify candidates for care management;
• Set up pre-defined care plans with problems, goals, interventions, and outcomes (For example; Diabetes, Asthma, and CHF);
• Modify care plans based on individual needs;
• Set up and conduct assessments (ACUITY includes the Case Management Adherence Guidelines (CMAG's) from CMSA containing Health Literacy, Medication Knowledge, Readiness to Change, Functional/Social Support, Adherence Intentions, Modified Morisky Scale assessments);
• Score assessments;
• Direct nurses questioning based on previous answers/knowledge through decision tree branching logic;
• Automatically create tasks based on answers, events and results;
• Automatically tailor care plans based on assessments and rules;
• View "all-in-one screen" care data for a patient including care plans, authorizations, and medications. The screens can be customized;
• Track the actions, progress, outcomes, time, costs, and cost savings;
• Generate Reports and Letters.

The ACUITY Authorization Module is used for utilization management and provides the ability to:

• Pre-Authorize/Certify Requests
• Execute Initial Reviews
• Perform Concurrent Reviews
• Conduct Secondary Reviews
• Perform Retrospective Reviews
• Authorize Referrals
• Generate Reports and Letters

ACUITY code sets include:

• HCPCS
• CPT
• ICD-9
• NDC (National Drug Codes)

ACUITY provides the ability to create and maintain Appeals.

ACUITY has comprehensive report and letter writing capability. You may choose to develop your own custom letters and reports specific to your needs or, like many of our current clients, you may elect to use one of our letters and reports already loaded in the system.

Create letters to patients and providers "right now" or "queue up" for scheduled printing. Documents can be sent by regular mail, e-mail, or fax. Letter images are stored in PDF format for easy retrieval.

Printing allows for current record information to be passed automatically into Reports / Letters. There is no need to re-input information.

More key features of ACUITY include:

• Search Wizard for finding patient and provider records and transactions quickly and easily.
• Task & Workflow Manager for creating, assigning, and scheduling tasks both manually and automatically (based on events or conditions) to a specific person or groups of persons. The Task Manager promotes consistent workflows and "mistake-proofs" the processes. The Task Manager is also used for sorting work by priority, date, and type of task.
• Work Timer for tracking time manually or automatically to report productivity and invoice for effort.
• Attachments allow any electronic document such as word documents, picture files, and lab results to be stored and retrieved in the ACUITY database.
• E-mail allows users to communicate with other ACUITY users and external recipients. All correspondence can be recorded, tracked and retrieved.
• Phone Call logging allows users to track inbound and outbound phone calls and create follow up tasks.
• Notes can be recorded anywhere and at anytime from within ACUITY.
• History allows review and audit of records. It tells when a record was created or modified, by whom, and what the change was. This includes HIPAA logging as to who accessed what records.
• Medications icon allows a quick view of the patient's medications.
• Benefits icon allows a quick view of the patient's benefits.
• Summary icon allows a quick view of "what's going on with the patient". This screen is customized to what you want to know quickly.
• ACUITY allows the addition of "user-defined" fields. Up to 40 user-defined fields may be added to any screen. If there is a field we didn't think of, you can add it.
• ACUITY has a flexible Security Module for ease of managing roles, access rights and permissions. Security can be maintained at the following levels: user, group of users, patient, module, screen, or field.