Integrated Risk Information Services
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Integrated Risk Information Services
Cost-efficient risk management requires the availability of up-to-date, organized data to make informed, effective decisions. To this end, GENEX offers managers easy access to the most current data integration, claims data conversion, and risk and employee benefit software services available. Here, they can compare the costs of their benefits with the world's largest collection of integrated health benefits data, and they can have the most recent risk management and employee benefit information delivered, on demand, directly to their desktops.
Claims Analysis
Accurate and timely integrated information, readily available the moment you need it, can help you increase the health and productivity of your employees. Expert analysis of current data concerning trends, healthcare costs, population risks and the factors that govern the duration of disability claims is available to you through GENEX.
We provide custom configured applications to support the management of our employer and insurance payer customers' investments in employee health and productivity. Among our offerings are customized reporting services and data integration services. We also offer the OCI FastTrackTM Risk Manager, a fully integrated risk management information system (RMIS), and integrated analysis and research services.
Predictive Analytics
For customers seeking a more scientific and non-traditional approach to the identification of high-risk claims that might benefit from targeted case management, GENEX offers the FastTrackTM Risk Analyzer. The goal of Risk Analyzer is to identify high-risk claimants for early contact and targeted case management intervention to reduce lost work time. The FastTrackTM Risk Analyzer processes First Reports of Injury (FROI) through a proprietary methodology and the FROI is compared against two years of historical claims data. The result is that each claim is assigned a unique risk score, based on our proprietary referral algorithm and criteria.
Risk Analyzer claim risk scores are a proprietary analytic methodology of the GENEX subsidiary company OCI (Options and Choices, Inc.) that was formulated based on the characteristics of past workers’ compensation and employee benefit use that can best predict future benefit use and cost risk. Risk Analyzer risk scores are not based on total cost alone. They are also based on the frequency, duration, and types of workers’ compensation and employee benefits used, as well as the nature of the medical conditions for which injured and disabled workers received treatments. The Risk Analyzer risk score methodology therefore accounts for both the severity and complexity of a workers' medical and lost time benefit use.
See more information at www.oci.com
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