Connecticut-based IntelliClaim, an industry provider in healthcare claims optimization technology, announced the general availability of IntelliClaim Performance Analyzer.
The solution helps healthcare payors streamline the task of effective claims activity monitoring by tracking processing performance more easily and reportedly cutting through the complexity of finding relevant events from within mountains of operational data.
Designed specifically for health plans, the Performance Analyzer is an
analytic tool that offers user-friendly, real-time access and monitoring of the claims lifecycle, to:
* enable proactive operational decisions based on accurate and timely claims data;
* provide immediate access to key business indicators affecting each manager’s role and department, as they occur;
* give access to valuable, relevant information when, where and how it is needed for effective financial, operational and clinical decision
making thru customized metrics libraries; and
* “pushed” e-mail notifications to notify managers and other stakeholders of any abnormalities in the claims process.
The IntelliClaim Performance Analyzer helps to streamline the massive amounts of data that health plans must wade through to find relevant operational events, drill down into the claim detail around an event, and view reports in user-specified graphical or text presentations. The solution broadcasts alerts to notify users of abnormalities in the health plan’s operations, improving communication throughout the enterprise.
User-defined metrics can have multiple alerts, based on selected thresholds, and the Performance Analyzer disseminates the message to various departments and managers. The alerting
feature helps health plans toward:
* quicker issue resolution;
* increased member, provider and group satisfaction;
* decreased costs; and
* overall improved efficiencies.
One of the key components of the IntelliClaim Performance Analyzer is the technology of IntelliClaim’s Hub Architecture. On receiving
claims from a client’s claim processing system, the Claims Hub translates, validates and loads the claim data into its Operational Data Store, intelligently linking related claims, and retrieving metric-specific data. Effective use of claim history enables alerts based on trending, time series analysis and normative comparison.
The IntelliClaim Performance Analyzer is also fully interoperable with
IntelliClaim’s core Enhanced Claims Editing solution.
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