U.S. healthcare reform legislation
will have the greatest impact on private insurers and
other payers. Among the most significant mandates are:
Guaranteed-issue
policies
Pre-existing
condition bans
Lifetime maximum
bans
Annual benefit
limit restrictions
Premium rate
restrictions
Extended dependent
coverage
Expanded mandatory
coverage for preventive services
Consumer web
portal requirements
Improved transparency
of information and audits
PluralSoft can help payers reduce
the risk of revenue loss, reduce overhead costs and enhance
quality of care with our combination of healthcare expertise
and industry-leading CLINICIO™ data-analytic software.
Benefits:
Gain faster access
to member health records in order to accelerate
the development of new products and self-care incentives
for consumers
Gain access to
clinical outcomes reporting from providers in order
to better analyze risk and administer new pay-for-performance
reimbursement models
Manage and integrate
the coming deluge of clinical and administrative
data from providers
Improve access
to quality care while reducing costs
Accurately predict
future costs in order to maximize your top and bottom
lines
