| PraxProofSM, our proprietary analytics
tool built from nationwide best in class solutions, provides
cutting-edge data to create a solid foundation for custom
cost containment strategies. Also a standalone offering,
this data-mining tool applies sophisticated algorithms to
cost data generated from health care coverage claims.
The result offers a multi-dimensional view of the actual
costs associated with the performance of each health care
vendor. Performances can be evaluated by a range of criteria
such as cost-efficiency, quality of care and experience
weighed against comparable benchmark groups. This information
improves upon vendor relationships by providing clients
with in-depth knowledge of their claims history to leverage
against future measures for cost improvement.
PraxProofSM can be licensed
as an ASP offering or outsourced as a service support
solution.
Claims Data Application
We take a comprehensive overview of the claims data
for the current fiscal year and break down the available
data using our PraxProofSM
technology to assess and identify all of the manageable
variables.
The claims are analyzed for billing errors, abuse, appropriate
referrals and expense patterns, as well as etiological
patterns reflecting inefficient or non-performing health
benefits elements and unfulfilled medical needs. This
service will often result in immediate cost savings from
analyzing these and other areas, including overpayment
and fraud.
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