Claim Analytics
Our team can help you make educated and cost-saving benefit plan decisions.
Recognizing that we see the same claims data that the insurance company does when pricing your risk, we believe that in order to bend the future trend of health insurance costs. Our team can analyze and benchmark - identifying which health risks are the greatest drivers of claim activity, model potential plan designs, estimate renewal costs and enhance employee decision-making—all designed to provide you with a benefits plan focused on driving down future costs and tailored to your unique business and employee population.
As part of our process, we seek to answer the following questions:
Why are my office visits so high? Who's going to the doctor? Why are they going? Are they using in-network or out-of-network providers?
Do my high-cost claimants represent long-term chronic care problems? Or were they caused by accidents?
Why are my members using the emergency room so frequently? Who's using the ER the most — employees, spouses, or dependents? Are they using it appropriately?
What does my group's experience show about disease management? What types of diseases should our communication pieces focus on?