Health Plan Claim Analytics
Consolidate all health insurance plan claims and clinical data to unlock the details of how and where healthcare dollars are spent.
Track and Manage Health Insurance Claims With Advanced Claim Analytics
Our advanced health plan claim analytics services provide self-insured employers with the ability to easily unlock the claims data. HealthCare Reporting consolidates your medical, pharmacy, clinical, and biometric data from your TPA and PBM. We then scrub, normalize, and quality-check the data before loading it to your white-labeled portal.
Login at any time to intuitively search all of your claims data, view dashboards, and access our on-demand report library.
Claim Transparency
No longer are employers and their consultants forced to ‘fly blind’ by building cost containment strategies with little to no data to support the effort. Our intuitive dashboards and claim search feature bring tremendous visibility and provide our clients with the information necessary to create highly targeted programs to manage their healthcare budget.
Through linking and optimizing your claims data, you will be able to easily drill down to the data you need and make informed decisions.
Actionable Insights
Quickly retrieve the information you need to assess key metrics of your health plans, such as high volume providers or providers, drugs and conditions that are the most expensive for your population. Finally, deploy strategies specifically targeted to your healthplan population, such as changing plan designs or implementing narrow networks.
The platform clinical approach is based upon The Asheville Project, which is most independently researched and peer reviewed disease management in existence.
Gaps in Care
When members have missing prevention services or fail to follow the necessary recommended protocols to care for a chronic condition, HealthCare Reporting flags these missing procedures or drugs. Clients can search for missing compliance items on the entire population of their plan or on a member-by-member basis. Each gap in care is categorized to make the information simple to access, use, and understand.
Print a personalized health report for members to provide them a road map to improved health.
Validate Effectiveness
After you have built and deployed your healthcare cost containment strategies, it is critical to follow the data to determine if your strategy is being successful. Through condition level risk scoring and trend analysis reporting you will have the data and validation needed to truly know how your efforts are performing.
Population health investments becomes easier to obtain and maintain when you possess data to measure return on investment.