PROJECT REQUIREMENTS: Records Management Software System for DCFS and Vendor Staff Use. Provide electronic records management of victims' files. Use includes but may not be limited to create/view victim client files, maintain provider information, organize documents, review claims, update claim statuses, send communications, record notes, manage payment information, search, apply multiple levels of approval for transactions, and run robust dynamic/ad hoc and template data reports. DCFS staff should be able to assign system access, access levels, and terminate user access. Application Receipt and Review. Receive victims’ applications and backup documentation from victims and providers, allowing for a variety of submission formats to accommodate victims’ situations. Review applications for eligibility, allowability, and completion. Establish victim client file. Notification to DCFS staff of new applications. Claims Review and Bill Negotiation. Provide claims and medical billing review for allowability, errors, fraud, waste, and abuse. Contact providers to request additional documentation as needed. Answer provider questions. Negotiate with insurance companies and providers.
