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PredictDx

PredictDx allows clients to easily evaluate and predict costs & clinical treatments for high dollar diagnoses by state with in-depth information on pending investigational therapies, pipeline drugs, and up-to-date physician commentary on standard of care treatment
  • Arbor Benefit Group
  • ASG Risk Management
  • HIIG Elite Underwriting
  • HM Insurance Group
  • HRMP
  • iisi
  • International Assurance Agency
  • International Insurance Agency
  • Iron Shore
  • MRM
  • RGA
  • Stay Well Insurance
  • TRU
  • TRU
  • Vista Underwriting Partners
  • Aran Insurance Underwriters
A web-based solution that combines clinical and financial analytics to address the challenges associated with catastrophic claims.
Features:
  • Billed and Paid Charges on the most costly diagnoses for all 50 States
  • 140+ Networks
  • Geo Zip Break Down
  • Medicare Reimbursement
  • 13,800 ICD9 Codes
  • 69,800 ICD10 Codes
  • 44,000 CPT Codes
  • 344 DRG Codes
  • Statistics Module
  • In-depth standard of care Treatment Information
  • Complications
  • Investigational Therapies / Pipeline Drugs
  • Physician Commentary
Benefits:
  • Quickly and proactively identify medical necessity and experimental/investigation issues
  • Triple your team’s productivity using a data-driven approach to process claims by eliminating the time intensive manual research methodologies based on disparate information, saving both time and money
  • Statistical data including inpatient claims of statewide and national average for billed charges, provider costs and average length of stay on the catastrophic diagnoses in PredictDx
  • Become an even more valuable and efficient partner by having access to the most comprehensive clinical and financial data available in minutes

What does becoming a PredictDx subscriber mean for TPAs?

Two out of every 1,000 people will have claims of $100,000+ and to stay competitive in an environment of larger and larger claims, Third Party Administrators need better data and tools to help minimize claim impact.

PredictDx is a subscription-based service which details billed and paid charges, risks, accepted treatments and other information related to the costliest catastrophic diagnoses, enabling healthcare payers and their partners to more accurately predict liabilities, set reserves, assess the need for cost containment, validate standard of care treatments and eliminate the countless hours spent searching for credible financial and clinical data.

With PredictDx TPAs Can:

  • Achieve up to $194,000 in savings from a typical 1,000 covered life pool by proactively managing reimbursement pitfalls
  • Reduce or eliminate the reliance on and fees from outside vendors (underwriting, negotiation, cost containment)
  • Create a new profit center by putting negotiation fees back in your pocket.
  • Negotiate from a position of strength using data analytics and by understanding what treatments are currently being paid at.
  • Eliminate the quote bottle neck associated with the labor intensive process of researching and quantifying costly diagnoses
  • Join the growing trend of TPAs who are solving the catastrophic claims problem with technology and data analytics products

Position yourself as an indispensable TPA

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What does becoming a PredictDx subscriber mean for MGUs, Stop Loss, and Reinsurance Carriers?

In the last five to seven years, we’ve seen a cataclysmic shift in the cost of care resulting in a huge increase in both severity and frequency of catastrophic claims. You can manage this!

Advanced Medical Strategies has developed PredictDx, our suite of online software products that combine technology and data analytics to meet the ever increasing demands and challenges associated with Catastrophic Claims. These specialized tools focus on the most costly diagnoses and allow you to optimally price business, accurately set reserves, and eliminate wasted labor dollars associated with diagnosis research.

With PredictDx, Managing General Underwriters can:

  • Price business adequately to compensate for known risks in the population by using real, accurate, and constantly updated catastrophic claims data
  • Support growth in earned premium, accurately set reserves, improve loss ratios, and profitability for current and future business
  • Triple your team’s productivity by eliminating the manual and time-intensive research mythologies based on disparate information
  • Accurately ‘pick and choose’ when to laser based on real quantifiable risk and provide a detailed clinical and financial assessment to more accurately substantiate findings
  • Quickly and proactively identify medical necessity and experimental/investigational issues

Click to Start Your Trial Today

What does becoming a PredictDx subscriber mean for a Medical Management Professional?
  • Join other cutting edge Medical Management firms meeting the ever increasing demands placed on them to get a handle on “High Dollar” claims.
  • Quickly and proactively identify medical necessity and experimental/investigation issues
  • Become an even more valuable and efficient resource to your client by having access to the most comprehensive clinical and financial data available for catastrophic claims
  • Accurately focus on the most costly diagnosis that can have the most adverse impact on your employer groups
  • Reduce or eliminate the reliance and fees on outside vendors (underwriting, cost containment, case management
  • Negotiating from a position of strength with data analytics by understanding what treatments are currently being paid at

Click to Start Your Trial Today

The Easiest & Most Comprehensive Directory

Underwrite lasers and policies, assess catastrophic claim costs, streamline your operations, and plan your reserves with the confidence of having the most comprehensive and accurate online claims information about real-world costs available anywhere. Gain exclusive consultation access to Advanced Medical Strategies’ Chief Medical Officer for underwriting assistance. Streamline your operations with this powerful tool, and plan your reserves with the knowledge that only PredictDx can deliver.

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