4 Claims Review

Claims Review includes a set of high level reports that provide a balanced analysis of the major dimensions of a benefit program. Top level reports point to areas of the plan with the most financial impact and the drill down feature makes it easy to dig into more detailed claims activity.

Claims Review is typically run yearly, quarterly, or even monthly and provides an overall analysis of plan activity for a specific group and time period.

  1. 4.1  Running New Claims Review Reports
  2. 4.2  Analysis Overview
  3. 4.3  Network Analysis
  4. 4.4  Benefit Analysis
  5. 4.5  Benefit/Network Analysis
  6. 4.6  Paid Claims Distribution
  7. 4.7  Diagnosis Analysis
  8. 4.8  Lifestyle Analysis
  9. 4.9  Member Relationship Analysis
  10. 4.10  Enrollment Activity
  11. 4.11  Member Age Group Analysis
  12. 4.12  Member Age/Relationship Analysis
  13. 4.13  Top 30 Providers
  14. 4.14  Provider Cost Allocation
  15. 4.15  Facility And Physician Analysis