SMART-UR: The Next Generation Technology for Medical Utilization Review

LOS ANGELES--(BUSINESS WIRE)--James Schlueter today announced the launch of SMART-UR (www.SMART-UR.com).

UR (Utilization review) is an effective tool to reduce unnecessary medical utilization, which is identified as the key driver in rising medical costs. However, according to Schlueter, “the current application of UR makes it a very blunt instrument that is expensive, inefficient and over-utilized.”

SMART-UR is a next generation web-technology that corrects the significant administrative burdens in the current UR process. SMART-UR uses proprietary and copy-righted algorithms that were developed by Dr. Lester Sacks from evidence-based medical guidelines such as AECOM and ODG. The protocols target the 600 most frequently requested medical procedures. The SMART-UR system can immediately identify and approve requests that fall within guidelines while it sends the questionable ones on for more detailed review. It can be applied at the claim level or even be opened up directly to an MPN for immediate approvals at the provider level.

Today, only about 20 percent of URs result in a modification or denial. “While that minimal level of effectiveness still produces a positive return, the process wastes significant time, money and technical resources,” Schlueter said. “More importantly, since UR inevitably involves delaying medical treatments to injured workers, the consequences of a poorly targeted, inefficient and over-utilized discipline are substantial.”

Schlueter said, “The speed, ease of use and cost-efficiency of SMART-UR allows its broad application. It can maintain the important sentinel effect of UR to control medical utilization, while not clogging the system down with unnecessary reviews. SMART-UR will allow effective doctors to spend more time treating patients rather than waiting around for UR requests to be approved.”

SMART-UR is an independent web-technology. “We are not a URO,” Schlueter said. “Consequently, the SMART-UR technology does not require any change in your vendors. SMART-UR is a management technology that simply makes the system more efficient and effective. ”

In fact, Schlueter stated that the SMART-UR system may be accessed by an insured’s URO or MPN at no charge. “In effect, SMART-UR is a cost-containment program for your cost-containment program. It keeps the UR muscle while eliminating the URO fat.”

The web-based SMART-UR solution is available immediately and is flexible to the needs of the clients. It is offered on a transactional fee basis.