Solutions for Payors.

Reduced risk. Lower costs. Greater efficiency.

That’s the dream, right—reduced risk, lower cost and better efficiency? Sometimes, it may seem like a pipe-dream, but IMIDEX can help to make it a reality. The very same predictive models and data interpretation that can save lives for a healthcare provider can help Payers to better manage claims. Whether it is accidental overbilling, unnecessary or over-treatment, or potential fraud, our predictive analytics can identify abnormalities that traditionally lead to poor outcome or unnecessary healthcare expenditures.

It’s estimated that 30 percent of medical expenditures are unnecessary, some potentially injurious. In U.S. dollars, that amounts to somewhere between $750 billion per year. Combine that with an increasingly complicated medical system, claims handlers need objective, evidence-based guidance more than ever.

the Continuum of care

Unlike other analytic solutions that consider only certain points in time, IMIDEX knows there is much more to the story. Our solutions monitor a claimant throughout the entire continuum of care to base our analyses on a robust spectrum of evidence about a medical claim, rather than an isolated statistical anomaly.

 How it works

 We create web-based solutions that are easy to use and, in most cases, bolts right on top of your existing medical billing and claims system and conforms to your claims handling philosophy and procedures. The technology is rooted in IMIDEX’s proprietary semantic network of medical concepts, developed through rigorous empirical analysis of medical data  and meta-analysis of medical research. Using this, we can help you more accurately stratify caseloads and produce clinical explanations and evidence to help guide decision making.