AUTHOR: Gordon MacMaster

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10 Health Insurance Trends for 2019

10 Health Insurance Trends for 2019

For an industry that has undergone immense change in recent years, 2019 looks to be more of the same for health insurance. Some of the pressures come from standard sources such as governments, employers and providers, while others are driven by broader demographic or technological trends. Whatever the root cause might be, health insurers will continue to value adaptability, cost containment[…]

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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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