Data Mining
Dig deeper into your claims data
Recover and reduce overpayment errors
Your health plan is committed to paying claims quickly and correctly, but you can鈥檛 avoid the millions of dollars that slip through the cracks鈥攃racks caused by older claims technology, ever-changing CMS rules and regulations, and a multitude of contractual terms.
Our comprehensive Data Mining solution not only helps identify and recover improper claims payments associated with adjudication errors, billing errors, or contract language but also works to fix the leaks, preventing the reoccurrence of these errors in the future. Our Data Mining service is available for many health plan offerings, including at-risk commercial, Medicare Advantage, Medicaid Managed Care, state Medicaid plans, and third-party administrators.
The latest in Data Mining
Blog
Three ways to tackle the high cost of waste
Administrative complexity continues to drive the high level of waste in healthcare. Learn how to reduce improper payments with an optimized payment integrity approach that blends advanced analytics with human expertise.
Ways we help
Technology
Our pre-pay and post-pay data mining solution runs on an integrated payment integrity platform that increases the effectiveness and precision of identifying claims errors.
Expertise
Our team of industry experts holds a deep knowledge of claims processing and continually monitors the industry for trends and regulations that can impact our clients.
Efficiency
Save time and money with actionable intelligence to correct claims, prevent future errors, and streamline your claims workflow.
What you get with 管家婆三期内必开一期鈥檚 Data Mining
Trusted partner
From implementation through delivery and reporting, we put health plans first in everything we do to ensure our Data Mining solution is fully aligned with your plan.
Custom concepts
We customize our Data Mining services to support your plan鈥檚 unique policies, combining industry-standard and client-specific elements to facilitate a smoother review process.
Business intelligence
Gain critical business intelligence to better identify overpayments and root causes across multiple years and categories.
Flexible approach
Our flexible, sophisticated analytics and logic, blended with human intelligence, help catch and prevent overpayments according to your specific business processes.
Data Mining expands your ability to go deeper into your data to uncover and recover overpayments previously missed by current processes鈥攄ecreasing your administrative expenses and overall per-member per-month spend.
Your Data Mining partner
Recover and restore value to get the revenue you deserve and make healthcare more affordable.
Prevent
Pinpoint overpayments and
root causes
Correct
Review and update your claims
processing workflow
Recover
Recapture overpayments
previously missed
