Claims Data

You Can't Manage What You Don't Measure

Identify Your Loss Ratio
A basic way to justify renewal actions
Cutting edge companies understand the importance of reviewing their claims experience. Our claims assessment analyzes and reviews past and present claims to determine how a company’s benefit dollars are being spent.

Benchmarking Annual Utilization
Statistics help companies rank their performance
Benchmarking is an established practice used by companies to determine benefit utilization. Our approach combines several benchmarking studies together to appropriately illustrate results and data while highlighting information that is specific to your company.

Audit Claims Frequently
Checking validity helps gain control
Industry leading companies recognize that checking or reviewing the validity of claims incurred by an insurer is frequently needed. As a service that is performed on carriers or third party administrators (TPA), we assist with a comprehensive claims audit process which is highly effective and recommended every two to three years.

Determine Root Causes
Working hard to identify the source
Minimizing future claims requires deeper review and analysis. Our approach examines data and then determines the origin of frequent problems. Identifying recurring issues allows companies to implement preventive measures.

Review Network Utilization
Choosing within the network has its advantages
What is the importance of choosing doctors and offices within a plan provider’s network? Our mission is to educate employees on the higher costs and reduced coverage incurred by choosing a physician outside of their network. By managing network utilization, companies develop better cost controls.

Analyze Hospital Stays
Attacking the plan’s largest cost area
Tracking the number of inpatient admissions is critical to effectively manage your employee benefits plan. We help companies analyze the cost and frequency of hospital stays and the effect it has on the bottom line.