Review Management System
Technology designed
around clinical review
Secure intake, intelligent workflow, quality control, reporting and client visibility, on a platform FOCUS built and owns.
Intelligent workflow
From case intake
to final report
Most independent review organizations run on general-purpose case management software. A system built for review starts from the determination and works backward.
Built for convenience.
Engineered for quality.
Case routing
Workflow rules assign the right reviewer based on specialty, licensure and conflict requirements.
Automated quality assurance
Structured checks support completeness, rationale quality and report readability, including Flesch-Kincaid grade-level analysis.
Live analytics
Operational and statistical reporting gives clients visibility in real time rather than in a monthly summary.
Context-sensitive help
On any screen, the help icon explains what that screen requires. Panel physicians reach productivity without a training backlog, which is what lets the panel scale when volume moves.
Platform capabilities
Built for secure,
accountable review operations
Client portal
Secure case submission, status visibility, document exchange and report retrieval.
Reviewer portal
Structured assignments, case materials, deadlines, criteria and report workflows.
Quality engine
Readability scoring, required-field checks, rationale validation and audit trails.
Analytics
Turnaround, volume, outcomes, correction trends and other operational metrics.
Security
HITRUST CSF r2 certified controls aligned with enterprise healthcare security and compliance expectations.
Integration-ready
Architecture capable of supporting APIs, data exchange and evolving interoperability needs.
Why owning the platform matters
Owning the system means a new review line is a development decision rather than a licensing negotiation. The expansion into external review, Independent Dispute Resolution and government audit work runs on one platform rather than three separate tools.
It also means the security posture is certified rather than asserted. HITRUST CSF r2 certification covers the environment where case material is received, reviewed and returned, which is the environment health plan security teams ask about.
Health plan data exchange is moving toward standards-based interfaces, and CMS interoperability and prior authorization requirements arrive for principal APIs in 2027. FOCUS tracks that transition as a platform requirement rather than a compliance afterthought.
See the RMS in action
Ask for a walkthrough of the FOCUS Review Management System and how it would fit your program.
Request a walkthrough