Welcome to the premier provider of payment integrity, risk management, and business intelligence solutions to identify and address excessive claims, prevent and recoup overpayments, and effectively manage the risks associated with high-cost claimants and group health underwriting.
“Within the first 3 months of using PredictPi, $11.5M of significant clinical issues were identified by the system that were easily impactable in the short term. In the long term, the estimated/projected questionable spend across the year is upwards of $46M.”
“Cancer treatment is unique to each patient. I appreciate that AMS provides a typical treatment course. It has been a life saver for me, especially when deciphering what the course of treatment may look like for cancer patients. I have a reliable resource that saves me research time every day.”
“We often receive RFPs with cases only containing drug names and other basic information. By utilizing Predict Rx, we’re able to view several different benchmarks for dosed costs and come up with the actual price of the given drug.”
“When we receive a fully insured conversion group without claims experience, CensusRater is the only tool we trust to determine whether or not to quote, set the appropriate spec deductible, and assign a competitive rate.”
“With the proliferation of specialty drugs, there is great value in adding Profiler data to our monthly review. It really augments our existing tools in identifying claimants and their potential costs.”
“Profiler helped us determine lasers for the upcoming renewal accounts. It has saved us several hundred thousand dollars in lasers that we would likely not have recognized without the system. We appreciate the constant upgrades.”
To further mitigate third-party privacy, security, and compliance risks, we maintain HITRUST CSF Certification for all the solutions we provide.