Health Insurance BI

Claim Analytics Solution for Health Insurance Needs

Health Insurance companies face numerous challenges in the operational front especially in terms of detecting fraudulent claims and provider payment abuse. These challenges lead to huge delays in the claims process and add to operation costs.

Fortunately, UBTI’s Claim Analytics solution with its state-of-the-art interactive visuals and drill down features, help payer organizations to address these challenges effortlessly. This solution has been developed based on 2 decades of experience in exploring health insurance data. The solution uncovers in-depth insights on the differences between potentially genuine and fraudulent claims at fingertips, that result in timely data-driven decisions.

The claim analytics solution helps in making decisions that result in achieving a quicker TAT for the claim process, while significantly reducing costs and adding customer satisfaction and trust. Additionally, the solution also addresses the needs of management executives in making critical marketing decisions and assessing business performance.

Modern BI – key components include:

  • Month on Month Loss Ratio Analysis Report
  • Claim Fraud Detection by Outlier
  • Claims Performance Reports
  • Fraud and Abuse management triggers
  • Insured Level Analysis Reports
  • Key Insightful Execute Dashboards

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