This application applies evidence-based clinical rule sets and advanced mathematical process to claims, membership and other data (lab, health risk assessment, etc) to identify high-risk members and rank them by need. Use these clinically based forecasts to allocate resources efficiently and intervene before adverse outcome occur and dollars are spent. Results are presented in an easy-to-use web interface. A few mouse clicks generates a list of members with diabetes and a profile of Impact Opportunities - areas that provide the greatest potential for intervention and management. Standard reports present clinically relevant data about expected inpatient, pharmacy, and ER use, along with total expense projections.

Benefits

• Maximize intervention efforts using the most accurate high-risk methodology available
• Improve operations and set competitive premium rates with superior medical expense forecasting
• Increase patient and physician satisfaction by providing clinically relevant, actionable information
• Rely on models “fitted” to your business environment
• Realize the benefits quickly; Risk Navigator can be installed in less than 10 weeks

PDF Version

For more information on this product and pricing contact us:
Phone: 800.446.3324 -or- email: sales@medai.com