Mitchell International, Inc., a provider of information, workflow, and performance management solutions to the property/casualty claims and collision repair industries, has announced the launch of the SmartAdvisor Utilization Review Decision Manager. It is a medical bill review application that integrates medical bill review and utilization review (UR) to deliver more accurate workers' compensation medical bill pricing adjustments. The solution provides clients the flexibility to apply a variety of state-mandated and nationally accepted guidelines as well as acting as a tool to implement their own custom UR guidelines and treatment plans.

The UR Decision Manager addresses financial leakage in the medical claims environment, which occurs when there is inconsistent application of utilization review or treatment plan decisions within the bill review process. The solution is powered by the Capstone Business Decision Engine, a business rules engine from SmartAdvisor that automates bill review and repricing decisions. The next generation SmartAdvisor UR Decision Manager will be available in July 2010.

"With SmartAdvisor UR Decision Manager, we are adding to our suite of flexible, highly configurable medical bill review tools in order to respond to a clear and compelling business need for automating and seamlessly integrating the application of utilization review within the bill review process," says Nina Smith, senior vice president and general manager of Mitchell's SmartAdvisor solutions division. "It's common knowledge in the industry that unenforced medical utilization determinations create significant financial leakage in the claims operations."