AMS Unveils PredictDx

Advanced Medical Strategies experiences rapid subscriber growth for PredictDx

 


PredictDx gives Health Care Payors, Carriers and Reinsurers unprecedented web access to clinical and financial details of 150+ diagnoses

AMS Unveils PredictDx PredictDx Logo RegisteredAdvanced Medical Strategies has changed the way carriers, reinsurers, MGU’s, TPA’s, and Brokers predict and manage costs associated with trigger diagnoses. Advanced Medical Strategies’ PredictDx is a new, patent pending software as a service (SAAS) subscription based offering. PredictDx details costs, risks, accepted treatments and other information related to more than 150 of the most costly catastrophic diagnoses, enabling health care payors to more accurately predict their liabilities for an illness. Since its launch last September, PredictDx has been enthusiastically received in the industry, accessed by more than 175 unique users including LifeWise Assurance Company, RGA Reinsurance Company, QBE North America, The Union Labor Life Insurance Company, HM Insurance Group, Arbor Benefit Group, Elite Underwriters, and PartnerRe America Insurance Company among others.

There is strong demand for more clinical and financial information in the health care industry. The Affordable Care Act has substantially increased the number of businesses that self-insure and because these companies pay their employees’ health claims directly, there is increased focus by third party partners to ensure that treatment is clinically and financially appropriate. Until PredictDx, many health care payors had to rely on the aggregation of incomplete data and educated guesswork in order to predict costs, leading to unnecessarily higher premiums and no standardized basis for identifying artificial inflation of provider pricing.

With PredictDx, underwriters, actuaries, claims professionals, brokers and consultants more accurately assess the real-world costs of a particular diagnosis. This keeps premiums in line with risks and reduces the cash reserves set aside to account for the unpredictability of medical costs. PredictDx equips underwriters, claims professionals and medical consultants with physician-reviewed information right on their desktop, reducing the time and expertise required to find comprehensive clinical information. The database further reduces costs by outlining accepted courses of treatment for claims reviewers, enabling them to more accurately identify claims for treatments that deviate from standard and accepted approaches to a diagnosis.

“As a nurse who has worked both in Underwriting and Claims areas for many years, I can honestly say that I haven’t found a more useful tool,” says Sharon McLane of The Union Labor Life Insurance Company, an early adopter of PredictDx.

With its growing success, Advanced Medical Strategies plans to expand the scope of PredictDx. It currently covers more than 150 catastrophic diagnoses, including 95% of all cancers, but Advanced Medical Strategies continues to add and update information.

“PredictDx and PredictDx Premier are just the beginning of what the future will be for claims and underwriting professionals who utilize Advanced Medical Strategies’ innovative suite of tools,” says Peter Borans, President of Advanced Medical Strategies. “With almost an instant ROI and AMS’ plan to add more modules already underway, our clients can continue to expect unique solutions that exceed their expectations and fill gaps in the marketplace..”


 
Advanced Medical Strategies is a physician-lead organization bringing innovative solutions to the health care payor industry. Based in Lynnfield, MA, Advanced Medical Strategies has been offering world-class claims review and cost containment services since 2003. For more information, or to schedule a demo, please click here or call Danae Lambeth, National Sales Director at Office: (781)-224-9711 x107 or email at danae@mdstrat.com

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