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Solutions for Top Concerns Facing Health Insurance CEOs

In our previous blog, we covered the top four concerns for health insurance CEOs for 2018. Now, here are some of the ways analytics can help address those challenges for improved operations and experiences for insurers, healthcare providers and patients.

  • Pre-Authorization Automation
    Pre-authorization can be accelerated by partially automating the analysis and decision-making process of a case. We develop the models and rules to reduce the overall workload per case reviewer, and in doing so, improve satisfaction and the efficiency of pre-authorizations.

  • Coordination of Benefits Identification
    Finding individuals who have multiple health insurance plans early in the process means reduced administrative work for providers and potential cost recoveries for Health Plans. We use sophisticated data mining techniques and scoring algorithms to identify people that have other health care coverage plans and reduce administrative efforts.
  • Reducing Emergency Room Visits
    We work with insurers to implement predictive models that leverage data to reduce the emergency visits, lower costs of care, shorten wait times and improve patient outcomes.

  • Reducing Readmission Rates
    Knowledge of the social and environmental factors that contribute to patient readmission can help clinicians make the right decisions when delivering care to reduce costly readmissions. Our analytics team uses an integrated toolbox of policies, processes and information help

Are these solutions of interest to you? Reliable can provide demonstrations, tools, counsel and so much more, to help you implement big data analytics. Contact us today to learn more.


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