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.
in claims analyzed.
patient events per month.
Our artificial intelligence platform is designed specifically for health insurance claims data.
Applied to your established processes.
Care coordination and utilization management
Capture cost avoidance from better outcomes while minimizing wasteful treatment.
Audit and investigation
Send higher value claims issues to audit by optimizing business rule filters and detecting anomalous claims.
Design higher impact coverage and prior authorization policies with advanced population-level models.
Manage risk more proactively by accurately predicting future events for high risk patients.
Develop data-driven insights to strengthen contract negotiations.
Population health analysis
Identify precise population-wide trends in disease management, patient outcomes, and successful interventions.
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
1. Identify Organization’s Pain Points
Target biggest problem areas for clients (e.g. cancer, specialty drugs, opioids, dialysis, etc.).
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.
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.
PrecisionGx Inc. – 1604 Locust St., 2nd Floor, Philadelphia, PA