You serve as the go-to person for any questions your client has with their provider. If they sense a red flag in their coverage, it’s up to you to ensure their satisfaction – or risk losing a renewal. Advocate for your customer and negotiate for better rates using the AMS knowledge base, PredictDx. By having powerful information at your fingertips with PredictDx, you can build your personal brand, solidify the relationship with your client, and secure renewals for the future.
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A PredictDx client received a new prospect with limited data regarding a baby diagnosed with congenital anomalies – DiGeorge syndrome. It was noted that there were several admissions and claims totaling $345,000. The client was able to access the syndrome in PredictDx, but realized there were different types of the illness which can have extreme outcomes. Not willing to risk high claims, especially with an infant, the client needed help. Since the client is a member of PredictDx, they were able to leverage their complimentary underwriting support and submit an underwriting review.
With limited information, AMS requested additional data. Requested data was received detailing specific diagnosis, admission, medications, an treatment plan moving ahead.
Case results: Primary diagnosis of DiGeorge syndrome-incomplete with multiple complications, including Tetralogy of Fallot, immunodeficiency disorder, chronic infections in newborn. Past care details revealed major care was completed and the baby was stable. Care moving forward should adequately be covered by spec level.
Outcome: No laser required and the case was sold! A win for the client!