Claims Financial Analytics

Quickly analyze all your claims data and gain new knowledge to solve your most pressing health care issues.

Claims data is the most valuable health data available, and it offers the broadest view of health care services provided to patients both within and outside of an organization. Health care organizations need to be able to access large sets of claims data, share analysis across the organization securely, and use these insights to improve quality of care and bend the cost curve.

Our solution transforms the way organizations use claims data. By creating a consolidated repository of your data sets and applying best-in class data quality and data management practices we will create an analytics-ready environment to access and analyze claims data. xtLytics solutions, created just for healthcare big data, enables organizations to generate complex claims analytics in near-real time.

Revenue Cycle Management

    • Revenue cycle management to get cash sooner
    • Optimize the limits for instant payouts and shorten claims cycle times
    • Identify the right procedure and diagnosis codes

Optimize Performance Based Payment

    • Cost dispersion and performance based payments
    • Measure and oversee the effectiveness of care coordination models and payment models
    • Make more informed policy decisions

Fraud Prevention

    • Identify fraud sooner and more effectively at each stage of the claims cycle

Forecast revenue/ Forecast staff and equipment need

    • Forecast cost for treating diseases by region and provider
    • Forecast loss reserve  accurately by comparing a loss with similar claims
    • Forecast the cost of health care services overtime to set premium rates or plan out-year budgets

Operations Efficiency

    • Prioritize and assign claims to the most appropriate adjuster
    • Identify high-performing providers and communities that provide cost-effective care
    • Enable targeted population health initiatives and interventions based on granular assessment of health care disparities across geographies
    • Create custom reports and layouts