When we receive regular claims information from one of our employer-based onsite clinics or even biometric data from one of our client population’s health fairs, we can take an even more detailed look and make better recommendations.
The Diversified Data Analytics team employs the power of predictive modeling, risk stratification, biometrics, and ongoing monitoring.
This ability to drill down into claims data allows us to isolate gaps in care, improper care, or other risk factors to uncover conditions before a member becomes a large claimant. We then work with our carrier partners to intervene, to improve member experience.
Gaps in Care
Using Predictive Risk Analysis Diversified can drill down into claims data to isolate any potential care gaps in an Employee Benefits plan that may not be providing adequate coverage or care for specific conditions.
With the ability to drill down into claims data, Diversified can use the information to evaluate how well a plan is or isn’t running and allows us to suggest plan changes as necessary.
Taking a detailed look at the data also allows us to get all the way to down to a procedure code. With this information, we can recommend providers or facilities that offer the same service at a lower cost to the employee.
When our Data Analysis team can look at a group’s past claims data, we can then make projections on future performance regarding chronic conditions. With this information, we work with clients to make appropriate plan designs and create wellness initiatives tailored to address the findings.