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There are 3 item(s) tagged with the keyword "Claims".

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Predictive analytics in healthcare helps manage high-risk patients

Predictive analytics in healthcare can benefit organizations two-fold. This technology not only helps better manage a population but also better handle claims and save money.

Tags: Predictive Analytics, Technology, Health, Actionable Data, Claims, Healthcare, Advanced Plan for Health, Poindexter, Nurse Navigator, Data, Risk Modeling, Chronic Conditions
Elements of Top-Notch Data Analytics Risk Engine

In today’s healthcare world, benefits brokers are primed to gain a competitive edge through harnessing the power of big data analytics. With the right analytics engine, brokers can streamline risk analysis to provide their clients with key insights – at micro and macro levels – that shed light on crucial aspects of their member population and generate actionable results (1 Year $1 Million Saved: CEBG). The next major step in healthcare technology is here and ready to assist in the effort to improve population health.

Tags: Healthcare, Data, Analytics, Engine, Benefits, Brokers, Insurance, Big Data, Member, Population Health, Insight, Claims, Management, Compliance, Preventive, Customization, Predictive Analytics, Care Gaps, Health, Risk Score, Identify, Admissions, Re-admissions, Employers
6 Costly Healthcare Myths

The healthcare system can be a confusing place for someone who is well, let alone someone who is sick and in need of help. Oftentimes, health plan members do not know their benefits and can seek care in the wrong place; like the ER when the problem is not urgent, or outside their network, which means they may incur an expensive and unexpected bill. This confusion can cause delays in treatment and less than desirable outcomes; as well as an increase of cost to everyone involved--from the patient to the health plan itself.

Tags: ER, Healthcare, Utilization, Health Plan, Hospitalists, Care Physician, PCP, Medications, Inpatient, Readmission, System, Members, Primary Care, Health Outcomes, Provider, Patient, Manage, Poindexter, Data, Claims
By Barbara Rutkowski - Vice President, Clinical Operations

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