BENAT - A proprietary software developed to assist plan sponsors to better understand what is happening to plan costs and how to achieve cost controls. BENAT is the primary support foundation for the above services.
Health Plan Auditor
Upon receipt of a complete claims data file we load plan parameters, correct plan name, data ranges and network fee schedules, press the "run auditor" button, and the system does the rest. Every claim is checked against each individual benefit - by plan. It includes deductibles, co-pays, co-insurance, plan limitations and exclusions. Reports are produced in Microsoft Excel for ease of manipulation and standard charting capabilities that allows chart options by report.
Plan Design Analyzer
In times of soaring medical costs - every plan sponsor and their advisors are faced with questions - costs vs benefits. What happens if you change from a $250 deductible to a $500 deductible. Eliminate the guesstimates. The plan design editor calculates many common plan design changes against ACTUAL plan data. Program in the plan changes - the system does the rest. As always - the results are in Excel format.
Medical Management Analyzer
The source of future plan savings will be derived from medical provider management. Medical Management requires the ability to track care on an episode basis. This allows supervision/direction from initial diagnosis through completed treatment. The disease Management component tracks treatment by specific diseases. Tracking - the foundation for a complete disease management program is the ultimate culmulating deliverable.
Correct Code Analyzer
This is the backbone of claims cost analysis. Here reports are provided that will equate savings of 5 to 7 percent of claims, duplicate claims, upcoding, unbundling, fraud, and unintentional coding errors are detected. The result(s) are potential savings of hundreds of thousands per year.
Health Plan Reporting
Production of both standardized and specific report packages and formats. Twenty-Five standard reports enable employers to view critical health plan information in electronic format. Of course enabling easy data storage for future manipulation and reporting. You can sort by plan, provider, claimant, procedure codes, diagnostic codes and by age or gender. With this module, custom reporting becomes effortless, fast and reliable.