SCIOinspire's professional staff brings decades of experience to the administration of health plans. With our care management, other-party liability and business process services, clients can focus on their core competencies, while we concern ourselves with optimizing outcomes and managing the costs of their health benefits.

SCIOinspire provides a broad spectrum of specialized services to support and improve health plan offerings. We offer technology product development to ensure you have the most effective tools in place to maximize performance. At the same time, SCIOinspire serves as your data management vendor, delivering ad hoc or standing warehousing and back-office support. Our expertise in analytics enhances opportunity assessment through predictive modeling and risk stratification - and strengthens outcomes reporting by validating clinical results and return on investment. Our robust PRO Series software is designed to facilitate program design and member identification (PROSpect), streamline execution of care management initiatives (PROGuide), and measure financial and clinical results (PROFormance).

All this means you can deliver benefits more efficiently and more effectively while helping employees remain healthier - which ultimately means healthcare costs will decrease and productivity will rise.

Pain Points

Self-funded and employer groups are concerned with:
  • Spiraling costs of healthcare and members coverage
  • Inefficient clinical and operational program design
  • Need to quantify clinical outcomes, financial ROI for care management programs
  • Absence of successful methods related to subrogation, coordination of benefits, auditing and recovery of overpayments
  • Need to concentrate resources on critical tasks
  • Reliance on paper-dependent processes
  • Insufficient data management and processes

Value Proposition

SCIOinspire delivers:
  • Outsourced or co-sourced opportunities that do not compromise accuracy, quality or consistency
  • Improved business process efficiency
  • Highly effective care management enrollment and member management methods
  • Risk assessment, predictive modeling and analytics to improve program design, execution
  • Tools to determine success of programs by evaluating performance
  • Increase recovery dollars - subrogation and COB - through better identification and investigation techniques
  • Access to data that can be used to evaluate operations to enhance programs, control costs and improve the health of plan members