Data Mining

Dig deeper into your claims data

Get in touch

Recover and reduce overpayment errors

Your health plan is committed to paying claims quickly and correctly, but you can’t avoid the millions of dollars that slip through the cracks—cracks caused by older claims technology, ever-changing CMS rules and regulations, and a multitude of contractual terms.

Our comprehensive Data Mining solution not only helps identify and recover improper claims payments associated with adjudication errors, billing errors, or contract language but also works to fix the leaks, preventing the reoccurrence of these errors in the future. Our Data Mining service is available for many health plan offerings, including at-risk commercial, Medicare Advantage, Medicaid Managed Care, state Medicaid plans, and third-party administrators.

Ways we help

Technology

Our pre-pay and post-pay data mining solution runs on an integrated payment integrity platform that increases the effectiveness and precision of identifying claims errors.

Expertise

Our team of industry experts holds a deep knowledge of claims processing and continually monitors the industry for trends and regulations that can impact our clients.

Efficiency

Save time and money with actionable intelligence to correct claims, prevent future errors, and streamline your claims workflow.

What you get with Data Mining

 

Trusted Partner

From implementation through delivery and reporting, we put health plans first in everything we do to ensure our Data Mining solution is fully aligned with your plan.

 

Business intelligence

Gain critical business intelligence to better identify overpayments and root causes across multiple years and categories.

 

Custom concepts

We customize data mining services to support your plan’s unique policies, combining industry-standard and client-specific elements, to facilitate a smoother review process.

 

Flexible approach

Our flexible, sophisticated analytics and logic, blended with human intelligence, help catch and prevent overpayments according to your specific business processes.

Data Mining expands your ability to go deeper into your data to uncover and recover overpayments previously missed by current processes—decreasing your administrative expenses and overall per-member per-month (PMPM) spend.

Your Data Mining partner

Recover and restore value to get the revenue you deserve and make healthcare more affordable.

 

Prevent

Pinpoint overpayments and root causes

 

Correct

Review and update your claims processing workflow

 

Recover

Recapture overpayments previously missed

Contact us today for more information on accelerating your payment integrity results

Get in touch
Discovery Health PartnersData Mining