Health insurance is becoming value-based | precise | competitive | data-driven | predictive

We apply AI models to your organization’s claims data to improve decision-making without disrupting existing processes.

Why build AI with us?

AI should work for you. Don’t reinvent the wheel.

More than

in claims analyzed.

More than

patient events per month.

Our artificial intelligence platform is designed specifically for health insurance claims data.

Artificial intelligence.

Applied to your established processes.

Care coordination and utilization management

Capture cost avoidance from better outcomes while minimizing wasteful treatment.
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Audit and investigation

Send higher value claims issues to audit by optimizing business rule filters and detecting anomalous claims.

Policy design

Design higher impact coverage and prior authorization policies with advanced population-level models.

Risk adjustment

Manage risk more proactively by accurately predicting future events for high risk patients.

Contract negotiations

Develop data-driven insights to strengthen contract negotiations.

Population health analysis

Identify precise population-wide trends in disease management, patient outcomes, and successful interventions.

Drug management

Customize prescription utilization based on previous trends and predicted outcomes.

Precise predictions for decision-makers built on millions of patient years in data.

Our AI models in care coordination have identified opportunities to increase the value of expensive screenings and therapies by 3-8X, creating $14MM in potential savings per 1MM covered lives. While our fraud, waste, and abuse detection models have the potential to increase the precision of traditional systems by more than 30%.

%

potential performance improvement over traditional detection systems.

in potential savings for precision medicine care coordination per 1 million covered lives.

How It Works

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1. Identify Organization’s Pain Points

Target biggest problem areas for clients (e.g. cancer, specialty drugs, opioids, dialysis, etc.).
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2. Locate Minimal Viable Dataset For Your Organization

Use most convenient data transfer option for your analytics team, requiring little to no bandwidth commitment.

3. Analyze data

Build advanced models and develop them into long-term assets for your company.
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4. Store Model in Our Secure Locker

Commoditize models in our secure locker – they are ready to use and yours to keep!

5. Capture Value from Models

Collaborate with stakeholders to put the models to use and capture real savings.

6. Track Results

Track financial and clinical outcomes, continuously improve models.

Contact Us

PrecisionGx Inc. – 1604 Locust St., 2nd Floor, Philadelphia, PA

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