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CareConnect Case Studies
Keystone Mercy Health Plan

CareConnect Solution
IntelliSource Healthcare Solutions provided an integrated medical management solution for Keystone Mercy Health Plan, the largest Medicaid managed care organization in the Commonwealth of Pennsylvania. RPR designed, developed, implemented and currently maintain CareConnect, a state-of-the-art medical management system. It includes a flexible case management solution that integrates with a variety of systems, in a real-time environment, including the primary managed care systems. It also provides real-time access to key member, provider, and claims information.

RPR developed the following components for Keystone Mercy Health Plan: 

    • Easy-to-use graphical application to streamline all relevant member and provider information
    • Turn key integration into all required back end systems
    • Work queue environment for case managers to effectively managed their case load
    • Automated care planning
    • Health risk assessment module for automated assessments
    • Alerts and triggers based on user requirements
    • Integrated call and issues tracking
    • Update capability for recipient address
    • Authorization entry
    • Accumulators to determine eligibility for new Pennsylvania Medicaid benefit changes
    • Customized reporting system
    • HIPAA compliance
    • Security
    • System maintenance, modifications, and enhancements

The CareConnect system has significantly improved the productivity of case managers and support personnel by providing a streamlined system that offers a consolidated view of all recipient and provider information. The system also provides users with a single system for completing health risk assessments (HRAs), care plans, and contact tracking.

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