Cambridge Integrated Services Group

 

Cambridge Integrated Services Group delivered what risk management insurance professionals have sought for years but could never find.
This was their website.
Content is from the site's 2003 -2008 archived pages offering just a small sample of what the Cambridge Integrated Services Group offered.

Cambridge Integrated Services Group, Inc.
4B Cedar Brook Drive
Cranbury, NJ 08512
800.662.1170 toll-free
609.655.8383
609.655.0503 fax
Sales & Marketing Division

James Robertson, Managing Director
Tracy Mock, Senior Vice President, Marketing

Cambridge Integrated Services Group is revolutionizing the industry as a single outsource solution for comprehensive, cutting-edge claims administration and loss cost management services.

More than a singularly focused claims services provider, Cambridge collaborates with self-insured clients, carriers, managing general agents and captives in managing their assets and liabilities to minimize financial exposure and to maximize bottom line performance.

Not only are our claim professionals thoroughly trained in best practices, they are knowledgeable and experienced in managing all aspects of a claim program. They focus on achieving uniformly high settlement quality, outstanding paid loss results on each claim, and positive financial outcomes for every client.

Quality, consistency, and bottom-line performance are the hallmarks of the full range of Cambridge's service capabilities

Cambridge’s outcomes management team conducts benchmark audits to assess performance against overall best practices and measure claim “leakage.” For self-administered clients, insurance company clients or TPA clients. Through these audits, clients learn where improvements can be made and how “leakage” can be reduced by adherence to best practice standards. We also offer this service on a consulting basis, and can engage the client's employees to further validate results.

Cambridge Integrated Services Group delivered what risk management insurance professionals have sought for years but could never find. Until now!

  • A national firm with an unprecedented array of claims and specialty loss cost management expertise and services.
  • The ability — and flexibility — to integrate and simplify risk management programs company-wide.
  • The experience and best practices to ensure quality and consistency.
  • A dedication to maximizing administrative and operating efficiencies.
  • The commitment to provide proven results that help enhance your company’s bottom line.

Because Cambridge looks at the big picture and focuses on outcomes, we can serve as a single source for virtually every need and assist in delivering the bottom line results our clients want. By integrating our complete range of service capabilities, we work hand-in-hand with our clients to help to maximize resources and minimize loss-related expenses, not just in one or a few isolated service areas, but organization-wide.

From managing workers' compensation and complex liability claims, managed care, and return-to-work initiatives, to providing recovery services, Cambridge meets a wide range of client needs.

With this multi-disciplinary approach and decades of experience, Cambridge offers a comprehensive array of services throughout our nationwide branch network. We deliver high quality, personalized services to clients in virtually every sector — manufacturing, retail, transportation, associations, insurance companies, municipalities, healthcare organizations, school districts, universities, and more.

Regardless of your company's size, the geographic diversity of your operations, or the complexity of your business, Cambridge addresses your most pressing concerns, identifies creative solutions, and marshals the critical resources to meet your risk management service needs.

Cambridge Managed Care Services

Cambridge Managed Care Services (CMCS) brings more than 15 years experience to managing the quality and costs of medical care for our clients' ill or injured employees. We apply the full spectrum of managed care techniques - medical case management, utilization review, peer review and medical bill review in order to contain the costs of both lost time and employee medical care, while remaining focused on returning the employee to work.

Through a comprehensive array of professional services, which can be bundled or unbundled, CMCS builds a customized medical and return-to-work management program for each of our clients. The objective of each of our services is the rapid return of employees to the workplace through aggressive medical management and utilization of the full range of employees' work-abilities.

 

In addition to our comprehensive PPO networks, Cambridge works directly with other specialty networks for durable medical supplies, equipment and diagnostic radiology services. We also offer clients the opportunity to participate in our pharmacy benefit management program.

Pharmacy Benefit Management Program
The pharmacy benefit management program provides access to nearly 50,000 retail pharmacies. Through this program we are able to reduce clients' expenses for prescriptions by at least 20 percent.
Durable Medical Equipment and Supply Network
Our durable medical equipment and supply network offers national coverage for thousands of products including orthotics, prosthetics, TENS, wheelchairs, and IV therapy. This network is also able to locate hard-to-find specialty medical equipment, which may be necessary to support an injured employee's recovery.
Diagnostic Radiology Network
Our diagnostic radiology network offers national coverage for MRI and CT services as well as regional coverage for EMG's. On average, this network reduces the expenses associated with MRI's and CT's by 50%.
Proprietary Medical Delivery Networks
To meet a client's special needs, CMCS can also customize a proprietary medical delivery network by contracting directly with additional physicians, hospitals, or ancillary providers. This unique service allows our clients to maintain existing provider relationships and patterns of utilization or add a particular provider or facility to their list of preferred providers. CMCS can also assist clients in the development of exclusive provider networks built upon the larger general PPO networks with which we do business.

Utilization Review

Cambridge Managed Care Services has designed a highly effective utilization review program which:

- Ensures that injured employees receive the most appropriate medical care for treatment of their injuries or illnesses
- Prevents payment for unnecessary treatment involving high-cost or frequently over-utilized procedures that can contribute significantly to increased workers' compensation medical benefit costs
- Using on-line, nationally accepted medical guidelines, our in-house utilization review nurses evaluate requested medical treatment against these standards of care. If the requested treatment does not meet the standards, our nurses will seek consultation with one of our physician advisors. Our physician advisers work with the injured employee's treating provider to develop a mutually agreed upon plan of appropriate treatment.

 

Medical Review

CMCS uses a state-of-the-art medical bill review system to ensure that all charges for provider services are appropriate and in line with relevant state fee schedules and reasonable and customary fees. Our software checks for "unbundling" of services and inappropriate coding of services. The software also identifies duplicate bills.
Our goal is to ensure that all appropriate fees are reimbursed and to deny all charges that should not be paid. Beyond ensuring that bills are coded properly, our software reduces fees to state mandated fee schedules and usual and customary rates.
In addition, the software automatically identifies when a bill is from a participating PPO provider. If a provider is a participant in our clients' PPO, the bill is further reduced to reflect PPO negotiated pricing.

 

Information Services

Cambridge has developed a user-friendly system known as the Cambridge Ovation Business Intelligence Suite, specifically for clients who want a sophisticated tool for consolidating and managing their claim and risk exposure data. Cambridge Ovation gives clients fast, easy access to the information they need to make informed decisions for reducing loss costs and implementing risk reduction strategies.

Cambridge Ovation is a web-based application that gives clients access to a variety of tools. Through the Ovation Suite users can access individual claims, view monthly loss runs and create their own reports, all of which can be saved and updated automatically. For power users, Ovation also provides access to multi-dimensional views of data for in depth analysis.

Ovation has been designed to provide all the resources you need to view, analyze and manage your program. Users simply login through a secured Internet portal using a web browser. Once security is verified you will have access to view a personalized News Box and to access claims and loss data in a myriad of formats.

Ovation

Ovation Claim Lookup provides the user with fast, easy access to claim information. The user has several options available to lookup claims. These options include being able to search based on claimant name, claimant tax id, or claim number. In addition, the user can get a list of claims based on open date and status. If the full name is not known, the user can search based on a partial name. All of these options are designed to provide the user with a quick way to get to claim information. The type of information presented on the claim includes financials, claim notes, injury code, cause code, injury description, etc. The financials can be drilled down to show detail information on both payments and reserves.

Ovation offers three types of reports - Standard Reports, On-Demand Standard Reports, and On-Demand Query Reports. The reports differ in that the two On-Demand Report applications contain prompts that allow you to customize the report parameters. The information contained in the monthly Standard Reports is static and changes only when Cambridge updates the reports that are posted on the portal.

Standard Reports
Standard reports are produced in a batch environment and are displayed in Adobe Acrobat format (.pdf) and can be saved or printed.

Current Standard Reports include:

  • WC Open Claims Through MM/DD/YYYY (Loss Run)
  • Liability ALL Claims Through MM/DD/YYYY (Loss Run)
  • Risk Management Incident Year Summary - Liability
  • Risk Management Incident Year Summary –Workers Comp
  • Loss Run by Policy Year – Liability
  • Loss Run by Policy Period –Workers Comp
  • Auto Liability Claims
  • New Claims by Location
  • Payment Activity Summary by Coverage and Location
  • Payment Activity Summary by Injury Date
  • Payment Activity Summary by Claimant Last Name
  • Total Incurred over $50,000
  • Payment and Incurred Summary
  • Monthly Check Register
  • Monthly Transaction Register by Claim Number
  • Monthly Transaction Register by Transaction Type
  • Repeater Report

On-Demand Standard Reports
Parameter-driven screens are available for running reports at anytime based on prompted values. Standard reports are also available as On-Demand Standard Reports, which contain prompts that allow the user to customize some of the information on the report. Since the information is compiled when you run the report, the report data is always current. Data available for On-Demand reports is sourced from Cambridge’s data warehouse which is updated nightly from the Cambridge Claims Administration system.
By simply clicking on the On-Demand Standard Reports link in your News Box, a list of available reports will display. Then click on the report you want to view and select the desired values and date ranges for which the report should be run. The new report will display in the Inbox.
In addition to running Standard Reports using the on-demand feature, there are additional reports available through this report application:

  • WC Lag Report Detail
  • WC Lag Report Summary
  • Claim Notes Listing – One Claim Prompt by Claimant Name
  • Claim Notes Listing – Multiple Claims Prompt by Claimant Name
  • Claim Notes Listing – One Claim Prompt by Claim No.
  • Claim Notes Listing – Multiple Claims Prompt by Claim No.
  • WC Claim Transaction Detail – One Claim Prompt by Claimant Name
  • WC Claim Transaction Detail – Multiple Claims Prompt by Claimant Name
  • LB Claim Transaction Detail – One Claim Prompt by Claimant Name
  • LB Claim Transaction Detail – Multiple Claims Prompt by Claimant Name

On-Demand Query Reports
The third report application, On-Demand Query Reports, provide more versatility than a standard ad hoc reporting tool. It provides a starting place for users to gather information, and to obtain detailed data on day-to-day aspects of their risk management program. It also provides the user with the ability to choose from a list of pre-defined queries or to build a query from scratch using the Query Wizard.

The Query Wizard allows the user to create queries ranging from simple lists, to filtered, grouped, sorted, or highly formatted reports. Users can easily add columns, summaries, and calculations to the query, and apply styles to the report body, the headers, and the footers. As the query is being designed, a visual representation of the ultimate results is always visible, guiding the user so that the final query provides exactly what the user had in mind.

What makes On-Demand Query Reports unique is the ability to create a query from not only the query application, but also from other Ovation tools. For example, a user may choose to begin their data analysis from one of Ovation’s sophisticated cubes. After reviewing the data from several different perspectives in the cube, the user may want to “drill through” to On-Demand Query Reports. At this point, the user can opt to select from the list of pre-defined queries or create a custom query. The benefit of drilling into On-Demand Query Reports through a cube is that the filters or criteria previously selected in the cube are passed to the query and the final report.

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