Our technology

Discovery Health Partners’ suite of solutions runs on our proprietary, 100% cloud-based Healthcare Analytics Platform. Integrating powerful data, analytics, and business process capabilities, this flexible and HIPAA-compliant platform empowers clients to efficiently manage operations, reduce cost and waste, and derive insights from their data in ways never before possible.

Discovery Data

Quickly and efficiently load, integrate, and analyze data from multiple sources, including claims, eligibility, and other systems to understand the full picture and produce a more accurate analysis. Data governance and quality controls ensure data integrity and a single source of accurate information.

Discovery Identification

Use multi-factor data mining and predictive analytics to find more opportunities to avoid costs and improve recoveries. We look across diagnosis codes, dollar amounts, member histories, and many other data points to actively identify more potential opportunities. Algorithms are continuously refined over time using intelligence based on a member’s prior claims data.

Discovery Case Manager

Use powerful and flexible workflow software to prioritize workload, track case activity, and house relevant case-related and plan documents. You’ll capture the information needed to support payment integrity processes beginning to end and create an audit trail to support compliance and tracking.

 

Transparency delivers power and control

Built-in reports and dashboards let you monitor work in progress, results, and trends so you can manage performance and drive improvements. Compare your results to key performance metrics, financial projections, and industry benchmarks.

Our benefits

Improve results

Clients report stronger bottom-line results through a combination of sophisticated data mining, improved business processes, automated workflow management, and better reporting. With greater transparency and insight into what is really happening, you’ll be able to monitor results, report to stakeholders, and implement meaningful enhancements in a cycle of continuous improvement.

Gain flexibility and control

Discovery solutions are available as fully outsourced solutions, SaaS solutions managed by your in-house team, or a hybrid of the two. Platform configurability lets you manage processes the way you work and view information in ways most meaningful to your business—define parameters that automatically assign work and prioritize cases based on your business rules, or view case information by a variety of filters.

Increase operational effectiveness

Discovery solutions save time, improve communication and collaboration, and increase efficiency. With all relevant information in a single place, workload management is easier and fully transparent. Speed and efficiency improve with robust tools, such as our automatic configurable letter generator, single sign-on, a database of other insurance providers, automatic faxing, printing/mailing services, web response sites for members, and ISO queries.

Our commitment

Discovery’s Healthcare Analytics Platform includes strict security measures and protocols that protect your ePHI according to HIPAA regulations. Our security program received a 100% rating from one of the nation’s top five health insurers.

  • Total data encryption. Ensures that data can only be read by authorized users.
  • Single-tenant data isolation. Isolates your data from other customers’ data on separate databases and/or servers.
  • Multifactor authentication. Adds a layer of protection by requiring more than one method for users to identify themselves.
  • Role-based access. Automatically provides correct access levels to different types of users based on login credentials.
  • Virtual private cloud. Provides maximum security and privacy with higher levels of control, performance, scalability, and accessibility for clients. Our virtual private cloud is hosted by Amazon Web Services.
  • 24×7 threat monitoring. Identifies exceptions and potential intrusions via continuous alert logic monitoring.
  • Disaster recovery. Includes a second data center as our cold recovery site.
  • Security governance board. Provides guidance regarding information security policies, procedures, and technology. This internal advisory group reports directly to the Board of Directors.
  • HITRUST certification. Actively pursuing HITRUST certification for managing risk and compliance.

Learn more

Cheat sheet for healthcare payment integrity

Health plans need faster access to better and more information to make smarter decisions about paying and recovering claims to minimize financial loss. With a cloud-based software solution, you can quickly, easily, and cost effectively provide business users with the modernized capability they need, while preserving your team’s strategic focus.

Innovations in payment integrity

By combining advanced technology such as data mining and cloud computing, with information analytics and improved business processes, this new generation of “intelligent” payment integrity solutions enables health plans to more efficiently and effectively manage programs including eligibility, coordination of benefits, and subrogation.

 

Rey VillarTechnology Overview