AUTHOR: Gordon MacMaster

Recent Posts

Top big data analytics challenges in health insurance

Top big data analytics challenges in health insurance

While the benefits of big data analytics for health insurers are increasingly well known, the unique nature of the health insurance marketplace does create challenges that require careful and strategic work by insurers and their partners to address.

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Predictive Analytics in health insurance: Retain high value customers

Predictive Analytics in health insurance: Retain high value customers

Customers don’t contact their insurer to let them know that everything’s great or that they’re completely satisfied with their service. Rather, they call when they think something’s not right.

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How to manage healthcare claim recovery

How to manage healthcare claim recovery

Most health insurer coordination of benefits (COB) models work on a claim-by-claim basis, identifying claims that may be incorrectly paid and flagging them for adjustment before moving onto the next claim. This works reasonably well, especially when powered by big data analytics, but is focused on the largest potentially-recoverable claims.

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Trends in healthcare coordination of benefits for 2019

Trends in healthcare coordination of benefits for 2019

While coordination of benefits (COB) used to be a relatively simple, albeit time-consuming process of tracking down payments already made, the rise of big data, data analytics and machine learning have turned COB into a dynamic and high-reward opportunity for health insurers trying to improve payment integrity and reduce administrative overhead in today’s tightly-limited marketplace.

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The Future of AI is Enormous

The Future of AI is Enormous

In the current state of the art, artificial intelligence involves computers processing data, identifying patterns in that data and learning to accomplish tasks more effectively over time. AI is already making a huge impact in organizations implement it to address business needs, but as software, hardware and networks continue to evolve, the potential for artificial intelligence is enormous.

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