In the complex world of healthcare and health plans, SCIOinspire delivers straightforward value by offering strategies, software and solutions that enable healthcare payers to advance their cost management agenda reducing expenses, recovering more revenue, optimizing resources and streamlining business processes.
Our industry-leading solutions are supported by time-tested software applications, developed by the highly skilled SCIOinspire technology team.
With 80% of health plan dollars directed towards medical claims reimbursement and $100 billion lost to overpayments each year, payers across the country are seeking results-based approaches to managing medical costs, streamlining operations and reclaiming or avoiding misdirected or excessive payments. SCIOinspire combines the expertise of clinical and analytical resources with advanced software applications to automate business processes and enhance business intelligence.
Without a doubt, its a tall order. But SCIOinspire has brought together thought leaders and innovative problem-solvers to target claims costs and provide a 360-degree view of opportunities to improve performance through:
While undergirding SCIOinspire solutions, our proprietary applications are also available to clients, delivered via software-as-a-service (SaaS) or internal hosting. With firsthand knowledge of our clients specific care management, third-party liability, recovery and cost containment objectives, SCIOinspire applications measure up to the highest standards of quality. We continuously upgrade and enhance our software to meet the changing needs of the healthcare marketplace and our clients.
- MY SOCRATES®: SCIOinspire brought together experts from accounting, legal, computer science and healthcare to create our subrogation, data mining and case management platform. Our proprietary software program effectively and efficiently imports, filters, scrubs, identifies, investigates, reviews, tracks, and processes large volumes of subrogation and third-party liability cases.
- MY COB™: MY COB™ is an identification and case management application that enables health plans to manage the entire COB identification, prevention and recovery process end-to-end. With MY COB™, users can also manage the recovery of incorrect payments, while building comprehensive databases to prevent future incorrect provider reimbursements.
- PROFormance™: This groundbreaking analysis and reporting application was designed for health plans and care management companies that need to calculate ROI and demonstrate savings to clients. The flexible application uses a dynamic and continuously updated data warehouse, giving end-users access to a variety of methodologies and comparison groups.
- PROSpect™: This advanced opportunity assessment application enables you to better understand opportunities within a select population, ensure proper program pricing, estimate appropriate staffing levels, and provide employer- and plan-specific cost/benefit estimates and reporting.
- PROGuide™: This cost-effective workflow system manages the complex process of identifying and segmenting individuals to be targeted for care management programs.
