Payers Need Advanced Claim Analytics

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In healthcare insurance, the claim is central to almost all parties involved in patient care. It contains every detail of a patient’s care – the diagnosis, status codes, procedure codes, condition codes, and much more. 80% of all premiums are spent on claims’ payment and associated handling charges. Therefore, efficient claims operations/management within the healthcare industry has a significant impact on profitability, solvency, and competitiveness. With so many claims to handle, payers don’t have time to sift through all of that data to evaluate each claim. However, payers may not make the best decision if they miss a valuable piece of information.

Payers Need Advanced Claim Analytics
By leveraging a real-time claim analytics solution integrated with performance measurement scorecards and predictive analytics tools, a payer can derive insights from their data to make claim decisions faster. This level of depth entwined with the precision of insights on claim processing cycle also supports the payer organization to analyze millions of claims per day leading to faster revenue generation.

Power of Payer Analytics for a Data-Driven Healthcare

Scalable Health’s IntelliPayer solution is built to support health plans in today’s transitioning healthcare environment. IntelliPayer solution implements data-driven innovations for designing better health plans, proactive care management, responsive member reporting, transparent provider performance measurement, and pay-for-performance initiatives. It enables healthcare payers to reduce medical costs, increase member satisfaction and engagement, develop sustainable providers, improve quality of care, and prevent healthcare fraud.

Better outcomes with intelligence for tomorrow’s healthcare insurance

These are some of the benefits of using IntelliPayer

  • Greater efficiencies of claims processing personnel – IntelliPayer helps to increase the efficiency of claims processing while improving the quality of personnel within the organization.
  • Accurate claims payments for reducing customer friction – IntelliPayer helps to provide accurate claims payments that result in expedited business transactions and higher customer satisfaction.
  • Lower administrative costs – IntelliPayer ensures that all your costs – medical and administrative – remain low. These savings can be passed onto the patients.
  • Higher Medical Coding Accuracy – IntelliPayer helps to detect errors in coding and correct them with automated suggestions.

As payers face the challenges of increased competition and ensuring member satisfaction, the ability to execute highly effective claims management has become critical for success. Using big data and advanced analytics platform is an exceptional valuable approach for helping payers improve claim processing to accelerate operational efficiency, contain costs, and enhance member retention and satisfaction. Combining predictive analytics with business intelligence and claim management systems helps payers to gain the full benefits of better claim processing cycle and significantly improves their bottom line.

Read our white paper which encourages the adoption of analytic capabilities as part of a “next-generation advanced analytics” architecture for better business benefits and faster claim cycles.

Advanced Claim Analytics

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