SmartSimple Software Inc. - Medical Claims Management

Medical Claims Management

Madhulika - Project Manager

Insurers (Insurer360°)

When Insurers select SmartSimple to facilitate their health claims related to automotive accidents, bodily injury or property claims they do so to reduce cost and gain transparency and compliance.

Independent Medical Examiners (IME360°)

When Independent Medical Examiners select SmartSimple, they enjoy the seamless transfer of case information with many insurers as well as third party assessors in their network.

Learn more about our Insurer360° and our IME360° on the Product Guide.

Benefits
Testimonials & Case Studies
FAQ

Business Intelligence - Get up-to-date information you or your Payors require at a glance with an extensive reporting system.

Centralized - Store and search all case documents in one place making it easy to track down the information you need.

Secure - Peace of mind knowing that our certified high security throughout the system CSAE 3416 (CICA 5970) and SSAE 16 (SAS 70) ensures that your confidential case data is fully protected.

"The overall value of SmartSimple has allowed NRVMS Inc. to organize our staffing and assessments issues in an effortless and accurate method of product execution."

Mr. Denys Remedios, President/CEO - New Realm Vocational & Management Services Inc.

"We cannot imagine working a file without using SmartSimple. This software has combined the needs of the various players in the insurance industry resulting in an environmentally-friendly system that saves us paper, time and money!"

Jim Franko, President - Total Rehabilitation Management

"Evolve chose the SmartSimple solution as its main file management and portal solution for its out of the box capabilities and ongoing customizable interface that permits Evolve to meet the demands of its customers across different markets permitting for the efficient secure real-time paper-less communication for all parties."

Scott Knight, President - Evolve Assessments and Diagnostics

"With the support we have received from Smart Simple it has allowed our company to focus on getting our job done with high speed and efficiency. The Sales and Support Teams understand the needs of our company - they are incredible."

Doreen Lerman, Operations Manager - CWC Assessments

Are multiple users "allowed" to view a particular file/claimant at same time?

Absolutely, though the file/client will be read only except for the first user.

Can we manage all locations?

For sure, as a web based solution the system is designed to be used from all locations including, home offices and external provider locations.

Can Calendars be set up for multiple Assessors and what information will be in the Calendar?

Yes, you can setup calendars for all assessors and the calendar will display all their assessment activities as well as other appointments and availability.

How much training will we need to get going?

Generally we recommend two half day hands on training sessions combined with no charge web refreshers.

In Ontario, can we submit invoices to HCAI from SmartSimple?

Yes, IME360° is fully integrated with HCAI in Ontario at no additional charge.

What reports are included in your base IME360° product?

Number of referrals received by referral source, Number of referrals received by referring company, Reports due from Assessor, Reports due to Referrer, Scheduled services.

Can we create our own reports?

Absolutely, the system includes an ad-hoc reporting tool that can be used by staff to create custom reports, charts and dashboards.

Do performance reports account for holidays and weekends?

Absolutely, the system supports both a holiday calendar and working days - so performance reports are always based on actual working days.

Can we export reports to MS Excel?

For Sure, all reports can be exported to MS Excel plus you can access any report directly from Excel!

Can I have dashboards?

Yes, both pre-built dashboards (graphic representations of information) and custom dashboards are available.

What letters are included in your base IME360° product?

Lots of letters including; Claimant Appointment Letter, Referral Confirmation Letter, Assessor Notice Letter, Transport Booking Letter, Interpreter, Booking Letter, No Show Notification Letter, Email Template for Cancellation Notification.

What advantages are there in upgrading to a full version of SmartSimple?

Our limited, Insurer sponsored version of SmartSimple only supports cases from the single insurer sponsor. The full version will provide the ability to run your entire medical business completely on the Solution.

We are required by an insurer to use SmartSimple, do we use their version? How do we login?

Insurers are precluded from allowing third party organizations to access their internal systems, so you use a copy of SmartSimple specifically for your company. This copy can communicate referrals back and forth with the insurers copy. Access is by way of unique web address plus an individual username and password.

How are documents uploaded into SmartSimple? How do we get scanned documents into SmartSimple?

Documents are uploaded by browsing your hard disk and attaching the documents to the claim. Some clients have used other system functions to fully automate and integrate the scanning and uploading of documents.

What is an External license?

An external license is a high value, low fee license that provides external access to all your partners.

Can using SmartSimple contribute to better outcomes for our Insurers?

SmartSimple provides insurers with a vastly superior approach to understanding the work that is being carried out by their partners.

Can I track other lines of business with SmartSimple?

Yes, many clients use SmartSimple to track multiple lines of business such as client support as well as contract and asset management.

Can I add notes to a case?

Notes are a vital feature of the system. Any number of types of notes can be defined, controlled by user role as to visibility and workflow enabled.

Can I store non-case related documents in SmartSimple?

Documents can be stored in simple on-line folders or associated with contact, companies, or other applications.

How can I track a vendors performance?

SmartSimple provides insurers with a vastly superior approach to vendor performance as the details of all vendor activities are available within the Insurer copy. Insightful reporting is available based on these activities.

North American SaaS Pricing

$95*/Month

Core User
High Usage

Core User - High Usage - Administrative and other key users associated with the internal organization and using the system (logged in) more than 40 hours in any given month.

Core (High Usage) - Internal Administrators, Insurance Adjusters

$15*/Month

Core User
Low Usage

Core User - Low Usage - Administrative and other key users associated with the internal organization and using the system (logged in) less than 40 hours in any given month.

Core (Low Usage) - Management

$200*/Month

Entire Community

External Group License - Casual users such grant applicants, external reviewers or client employees who are not core users. These users are not billed by actual usage but by concurrent usage. Note "Concurrent users" are defined as users who are logged in simultaneously to the system. A client can have any number of users in the group but will only pay for the maximum concurrent users in any given month.

External - Consultants

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Configuration Fees

*Volume discounts available

Contact emea@smartsimple.com for pricing outside of North America.

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