Knowledge Is Power

Mitigate high-cost claim overpayments and predict future liabilities by turning raw claims data into actionable strategic intelligence. Focused solely on the most expensive and complex claims, our Predict Platform forensically identifies, financially analyzes, methodically predicts and clinically evaluates treatment appropriateness. The results allow payers and risk entities to effectively manage their plan and project risk. After all... Knowledge Is Power.

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Special Problems Require Special Solutions

We built The Predict Platform specifically to analyze, identify and report on the 5% of members driving 50% of total medical spend. ​Our innovative platform is a data driven analytics powerhouse able to pinpoint the drivers of high-cost claims that PBMs and cost-containment companies are ill-equipped to find.

Special Problems

Drivers of High-Cost Claims

  • Catastrofic diagnoses

    Catastrophic Diagnoses

    2.2% of claimants generate 23% of total reimbursements

  • Specialty drugs

    Specialty Drugs

    Represent 2% of total prescription volume but account for 50% of total drug spend

  • Implants

    Implants & Devices

    Nearly 6% of all medical costs totaling over $175 billion annually

The Predict Platform

We weren't impressed with the status quo of one-dimensional health plan analytics ... so we did something about it.

We built an innovative healthcare IT platform powered by thousands of in-depth clinical review algorithms and advanced financial analytics to deliver the next generation of insight into high-cost claims. The Predict Platform quickly analyzes data to seek out specialty drug claims, inflated medical implant charges, and clinically inappropriate treatments and dosing regimens.​

With dynamic reporting capabilities, continuous database updates, clinical insight and projections for high-cost members, The Predict Platform provides the strategic intelligence required to confidently guide business initiatives.​

The Predict Platform is undeniably the most comprehensive and versatile resource for intelligent data analytics available today.

  • Our cloud-based platform that enhances risk mitigation efforts with three modules focusing on a specific cost-driver; Complex Diagnoses, Specialty Drugs and Medical Implants.

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  • FACS is a financial and clinical surveillance engine that leverages the Predict Suite to automatically examine claims, flagging those that warrant additional review.

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  • Profiler leverages Predict Suite analytics to identify, report on, and project future costs of members with catastrophic diagnoses.

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Housed on the Predict Platform, the Predict Suite includes three continuously updated data modules, each focusing on the three main cost-drivers. Each includes clinical insights and financial analytics that encompasses data representing the entire payer marketplace.

  • Catastrophic Diagnoses

    In-depth clinical and financial data for the costliest diagnoses

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  • Specialty Drugs

    The ultimate resource for specialty drug data and spend

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  • Implants & Devices

    The only fully transparent implant cost directory in the marketplace

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One Platform. Several Solutions.

The Predict Platform's comprehensive clinical insights and physician commentary streamlines time spent by case managers searching multiple single solution platforms.

It's advanced financial analytics flag high-cost claims for that require immediate attention and predicts future courses of treatment and costs for members with complex diagnoses.

A powerful resource with enterprise-wide solutions.

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AMS has earned Hi-Trust CSF Certification to further mitigate risk in third-party privacy, security, and compliance. This certification applies to the entire Predict Platform: FACS, Profiler, and the Predict Suite (PredictDx, PredictRx & PredictIx).

  • Payment Integrity

    Payment Intelligence

  • Network Performance

    Network Performance

  • Predictive Analytics

    Predictive Analytics

  • Network Contracting

    Network Contracting

  • Member Reporting

    Member Reporting

  • Clinical Intelligence

    Clinical Intelligence

  • Financial Analytics

    Financial Analytics

  • Specialty drugs

    Specialty Drug Updates

Features and Benefits

  • Strategic Inteligence

    Strategic Intelligence

    Dynamic dashboards report key information quickly and clearly

  • Subscription-Based

    Monthly fee schedules based on individual module or full product catalog

  • Minimal Integration

    Minimal Integration

    Cloud-based SaaS platform works independently of existing systems

  • HIPAA Compliant

    Compliant and Secure

    Data integrity is essential, which is why AMS is HIPAA compliant and HITRUST certified

Contact Us

50 Salem Street
Building A, Suite 106
Lynnfield, MA 01940