Reinsurance
What is the time value of loss? For reinsurers, whether employer stop-loss or excess of loss for health plans, it is all about risk. How could you better manage risk and mitigate loss if you had earlier access to claim and utilization data? Could you better manage your risk if you could see claim activity the same day it reaches your TPA and health plan partners and customers? How about if you could see all of claim activity from many, even dozens, of your payer customers in one location. And what if a data analysis and reporting system was searching for claims every day with your trigger diagnosis or spec amount criteria?
Benefit Informatics provides reinsurers a proven process and system to monitor and be informed of new developments in their risk pool. We bring together claim, eligibility, pre-authorization, prescription/PBM, case management and other data sources in one data warehouse.
What could you do with actionable information like this?
You learn about a claim with three trigger diagnosis indicators hitting the door of a TPA partner today instead of 60 days from now.
You learn that a patient is referred for cardiac surgery to a facility with less than 30 similar cases per year and you have provider relations with several centers of excellence facilities.
A large claim is missed by a processor, but your data analysis and reporting system identifies the claim and includes this information in an automated email report hyperlink sent to your inbox.
You learn about a claim with three trigger diagnosis indicators hitting the door of a TPA partner today instead of 60 days from now.
You learn that a patient is referred for cardiac surgery to a facility with less than 30 similar cases per year and you have provider relations with several centers of excellence facilities.
A large claim is missed by a processor, but your data analysis and reporting system identifies the claim and includes this information in an automated email report hyperlink sent to your inbox.
Reinsurance, like all insurance, is about risk. How can you better manager yours?
Our Reinsurance Solutions
-
Data Integration
-
Data Warehouse
-
Data Analysis & Reporting
-
Plan Modeling & Forecasting
-
Healthcare Analytics
-
Healthcare Financial Analysis