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UB Technology Innovations, Inc. - Health Insurance Claim Analytics

UBTI unveils Interactive dashboard reports and enables Insurers & TPA’s to measure the Industry Key Metrics and dramatically improve the business results.

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Claim Analytics Solution for Health Insurance

UBTI’s comprehensive analytics solution enables Insurers & TPA’s to make fact based decisions. As a leading BI solution provider, we provide innovative business and technology solutions to pinpoint potential issues that impacts profitability and causes loss.

Our interactive Claim Analytics solution provides key insights on  Month on Month Loss Ratio, FAMS Triggers, claims expense analysis with various attributes like procedures, diagnosis, city, state, age, gender, fraudulent claims, and so on for insurance/TPA sectors. This Analytical solution helps Insurers and TPAs to cut costs, boost margins, increase customer satisfaction, lower litigation costs and to improve claims effectiveness and detect fraud & provider payment abuse.

Claim Analytics Solution Highlights

Key highlights of the solution are:

  • Insightful Dashboards - Enables to quickly understand the overview of claim statistics in a single screen
  • Fraud Analysis – Helps to Identify and reduces loss due to Fraudulent claim
  • Loss Ratio - Enables Insurers to understand claim performance and take decisions based on it to avoid loss
  • FAMS Triggers – Enables insurers to analyze, identify and unearth provider related claim abuse

Key Performance Indicators (KPIs) Include

  • Month-on-Month Increase in Loss Ratio
  • Loss vs Premium analysis with Claim amount
  • Monthly Claim Trend by Fraud Outlier Level
  • Procedures with maximum Fraud Outlier Level
  • FAMS trigger - Insurer and provider city mismatch
  • Most Expensive Procedures and diagnosis and more….

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