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Predictive Intelligence Profiles
Analytics-Informed Medical Management
 
Based on analysis of historic data, MedMetrics creates Predictive Intelligence Profiles containing data elements predictive of complexity and cost when they occur in claims. MedMetrics continuously monitors the data and when the data in a claim matches that in a profile, an Alert is sent to the appropriate person(s).

Predictive Intelligence Profiles can be set to alert claims reps of the need to update reserves and/or Nurse Case Managers and others of medical risk in claims such as a comorbidity like diabetes. A profile can be set to alert the right person for a prescription for Opioids so early intervention can be mobilized. Authorized users can also add to, or edit the profiles any time.

MedMetrics' Predictive Intelligence Profiles and Alerts create accuracy, efficiency, and consistency in the organization's medical management process. They promote early intervention that saves real dollars. Moreover, the consistent process lets users objectively measure cost savings.

Additionally, MedMetrics keeps an Audit Trail of Alerts sent, to whom they were sent, when, and for what reason. The Audit Trail is an easy supervision and accountability tool and assists in allocating costs.

Analytics-Informed Medical Management-elegantly simple, yet powerful!



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