One of the best teams in the country on claims based analytics, we have experience in working with the entire National Claims Data, and additional external data sources to allow our customers take important business decisions based on our analysis. Some of the ways we have helped our clients are as follows
Physician Network and Referral Analysis:
Hospital and ACO management need to understand who are referring to their physicians and what proportion of their clients are being leaked to competitors within their market area. We have developed Loyalty and Volume Score for physicians in the network within the defined market of a client organization and helped identify the most likely physician’s practices that can be acquired to improve business.
With increasing volume and velocity of health data, inference across networks and semantic relationships between the health organizations becomes a greater challenge leading to duplicate entities and linkage issue. We use a similarity quotient approach to generate a single entity key by standardizing the organization names and resolving different keys for the same organization using similarities of locations
Targeted Campaign for Hospitals:
Propensity Models for largest hospital chains in the US to determine prospective consumers for health products related to specific service lines using claims data for patients and survey data for potential consumers in the market area. Models were developed for more than 65 different diseases with patient models having more than 75% response rate and consumer models with greater than 65% success rate.
Workers Compensation Claim Analytics:
We help our clients identify claims that are likely to escalate based on the information available the day of the accident (0-day) and also at the 30 day level so that the insurer is able to allocate resources in proportion to the severity of the case.