The Data Analytics App can integrate data from multiple sources, such as claims, member eligibility, benchmark, clinical, financial and even prescriptions. We begin with Base Integration, which requires paid claim and eligibility information. You can also customize the sources of data to enrich your Data Analysis and Reporting capabilities by including:

• In-process claims
• PBM/RX claims
• Fixed cost and fee information
• Reinsurance reimbursement amounts
• Pre-certification details
• Case management notes

The Data Analytics App can integrate multiple adjudication systems, provide daily refreshes of data and allows you to access your data for multiple reporting scenarios. We even provide technical and process support for data loading and management.

Our Data Analytics App allows you to create a data warehouse to suit your business needs. Your data will be incorporated into a secure data center which facilitates daily data uploads to allow access to the most current information. What goes into your data warehouse is up to you. After the Data Analytics App identifies your data sources, the data is cleaned, validated and organized to make it simple to access and analyze. Our data warehouse permits data feeds from multiple sources and requires a Username and Password for secure access by multiple users.

The Data Analytics App provides employers with more than 30 standard reports and search capabilities to access precise information. You can also take advantage of ad-hoc reporting tools to build custom reports, which drill down to provider, diagnosis, procedure and individual Explanation of Benefit (EOB) levels.

Our Data Analysis and Reporting features and functionality include:

• Health plan utilization and cost analysis by provider, procedure or diagnosis
• Frequency and cost information associated with key health service groups
• Health expenditures for a specified time period, company or department
• Graphical summaries of expenditure, discounts and cost sharing arrangements
• Comparisons to benchmark data by industry, location and size
• Prescription drug utilization resulting from preventable medical conditions
• Summary-level trend analysis by diagnosis groups and employee age groups
• Graphical and data analysis tools for managing high claimant situations
• User-defined selection criteria for advanced searching
• Ability to export data to spreadsheets or database files

Our Data Analytics App allows you to create plan models using a variety of plan considerations. You can add and/or remove benefits, plan members and other variables and then calculate plan, employer and employee costs. The app allows simple changes to plan design, such as co-payments and deductibles, as well as intricate modifications. Our plan modeling and forecasting features and functionality include:

• Forecasting future health benefit costs based on historic information
• Providing flexible, user-defined source data selection criteria
• Defining selection criteria including co-pay, coinsurance and contribution changes
• Allowing addition and/or removal of catastrophic cases
• Modeling by employee population, diagnoses and health inflation
• Analyzing variations in health plan design and insurance coverage
• Filtering search results data by total cost, employer cost and employee cost
• Customizing plan model scenarios using specific employer group claim experience
• Studying book of business information for preventable conditions and reduced costs through changes in wellness behavior

Users can access claims, eligibility and plan information stored within the Data Analytics App via an online desktop. Employees can access claim status and EOB, and providers can access eligibility and claim status information. Our member and provider communication features and functionality include:

The Data Analytics App provides access to Member and Provider Communication 24 hours a day, seven days a week via our Software as a Service model.