MODBI Health Insurance (AAS) Analytics As A Service solution helps insurance companies to reduce cost and improve efficiency by providing detailed insights into key areas such as provider contracting, benefit plan design, claims processing

WHAT DOES HEALTH INSURANCE ANALYTICS  ANSWER?

  • High Cost Providers

  • High Cost Admissions

  • High Cost Procedures

  • High Loss Employers

  • High Cost Claims

  • Claims Submitted incorrectly by Reason.

  • Claims Life-cycle (Time Spent in State)

  • Claims Processed on Time

  • Status of Open Claims

  • Claims Past Due Date

  • Claims by age, gender

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KEY METRICS

•Amount Paid

•Amount  Paid Per Member Per Month

•Amount Paid % of Total 

•Amount Claimed Not Yet Paid

•Amount Premium

•Loss Ratio

•Count of Members

•Count Of Providers

•Count of Claims

•% Claims Processed automatically

•% Claims processed First time

•% Claims Submitted Incorrectly

•% Claims Processed on time vs Late

•% Claims Processed vs Received

•Claims Processed Per Employee

•Average time to close the claim

•Forecast vs actual performance

FEATURES

•Customizable

•Ad-hoc Reporting

•Excel Pivot tables

•Built in Time intelligence for calendar and Fiscal Years

•Ability to upload Plan/Forecast

•Advanced Threat Protection

•Row Level Security

•Access Anywhere

•Export Features, Comment

•Data of any size and shape

•Subscriptions, Alerting

•Source System Agnostic