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Addressing Key "Coordination of Benefits" Challenges with Data

According to the Census, over 20 percent of the population has more than one health insurance plan. Accurately identifying these individuals can lead to fewer errors in the coordination of benefits process, reduced administrative work for providers and potential cost recoveries for health plans, and analytics can help.

Data Warehousing

Patient information can come from a number of sources, including insurers, providers, government bodies and even social media. The first step in leveraging analytics to improve the coordination of benefits process is to ensure your data is accurate and organized. This should be in a way that makes it easier to access the information you need and effectively and efficiently perform analytics. A modernized data warehouse can help organizations sort information based on what is most important to help them make decisions and improve processes.

Data Mining

Processing large quantities of patient information can get messy without automated support from data mining. This technology leverages artificial intelligence, machine learning and business intelligence to sift through mass quantities of information, identify important patterns and drive more informed decisions.

Customer Analytics

With the information you need available and accessible, analytics can be implemented to help your organization identify members with the highest probability of having multiple coverages. Analytics can deliver insights to reduce the cost of benefits coordination and improve payment integrity. Through predictive analytics, insurers can look at factors like age, demographics and disease categories to more identify those most likely to be covered under multiple plans.

Contact us today to learn more about how Reliable Software’s sophisticated solutions for insurers can help identify people with multiple health care coverages.


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