- Pricing – compare your allowed amounts to the RJ methodology
- Site of Service Pricing – compare allowed amounts by office, outpatient, etc.
- Pricing by NPI – rank providers by over-reimbursement volume
- Max Dosing – identify outliers for FDA and Compendia uses
- Diagnosis Code – assess the viability of your ICD-9/10 data
- NOC Codes – determine permanent HCPCS availability
Many of our Payor customers are asking where to focus and how to prioritize their efforts when applying our data to their Medical Drug management processes. To help each organization understand the potential impact of applying our data, Claims Analysis evaluates your historical claims and provides a summary report which highlights the potential impact of each focus area: