In recent years, healthcare costs have surpassed 16% of the Gross Domestic Product and are continuing to rise. The market has also seen a lack of transparency in the aggregated information being provided to self insured groups.  As a result of the continued rise in costs and lack of transparency; self-insured companies have begun to ask more questions regarding their healthcare claims in two key areas: 1) payment processing accuracy and 2) transparent data analytics and metrics.

West has developed an innovative web-based platform, IntelliOpt, which integrates health claim data from multiple administrators and delivers otherwise complex and disjointed healthcare claim information in a visually smart, organized, actionable and real-time dashboard. IntelliOpt capitalizes on West’s 25 years of experience within the payer market, and combines traditionally siloed analytics and services with potential cost savings opportunities.

IntelliOpt is unique from other similar type products in the market. In fact, there are several areas that differentiate IntelliOpt:

• Finding the Needle in the Haystack

• By systematically applying our anomaly identification edits across all paid claims IntelliOpt can present only those claims that appear anomalous and at a minimum should be reviewed for payment accuracy as they may have been overpaid.
• With IntelliOpt the claim anomalies that are identified can be presented through an organized workflow.

• Providing Actionable Information

• The analytics provided on IntelliOpt not only display a clear picture of your healthcare spend, but also provide the detailed claim line and procedure information that is needed to make decisions supported by the data.

• Solution Oriented

• IntelliOpt offers the ability to utilize the data to support multiple services. The ability to provide subrogation, member outreach and other services driven by the data can provide opportunity for additional cost savings.

• The Benefit of Support

• With the use of IntelliOpt each client is provided a Dedicated Healthcare Advisor. Your assigned advisor is responsible for taking a deeper dive into your healthcare data, including providing root cause and other actionable information.

Information displayed on IntelliOpt is driven by utilizing the claim and membership data provided by a self insured’s administrator including: medical and pharmacy claims data, and membership eligibility data. West will work with you through the process of obtaining this data from your administrator(s). Once the data has been obtained West can complete the on-boarding process in as little as 60 days.

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West Corporation - IntelliOpt