6 Ways Your Health Plan Can Turn Data Mining into a Powerful Overpayment Recovery Tool

August 02 2018 | by Lalithya Yerramilli in Payment Integrity

Like other consumers, health insurers don’t enjoy feeling the pain that comes with the realization that you’ve paid too much for something. As such, they are known to employ a variety of strategies as part of their overpayment recovery programs.

Next Gen Behavioral Analytics: The How, The What, The Challenges

July 31 2018 | by David Hom in Health Analytics

Employers of all kinds, particularly those who have a high percentage of employees with chronic conditions, often struggle to determine which health benefits will support their efforts to maintain a healthy workforce. Often, employers turn to their benefits brokers to guide them in the right direction. Brokers today leverage advanced analytics that use robust data sets in order to confidently provide data-driven consulting to their employer clients.

4 Ways Patient Personas Can Help Pharma Companies Bolster Market Expansion

July 25 2018 | by John Pagliuca in Life Sciences

When people first meet – whether it’s on a blind date or as college roommates or as new work colleagues – questioning ensues: Where did you grow up? What hobbies do you have? What kinds of food do you like? By getting to know one another, we know how to interact with each other.

Poll Participants Weigh in On Risk Adjustment Model Readiness

July 19 2018 | by SCIO Health Analytics in Risk Adjustment

During a recent webinar entitled Call Letter Chat: Understanding and Planning for CMS’ Policy Changes, Tom Peterson, Senior Vice President, and Pam Klugman, SCIO’s Risk Adjustment Expert, explained not only why it is important to understand all the details of the new Centers for Medicare and Medicaid Service's (CMS) Hierarchical Condition Category (HCC) Risk Adjustment Model outlined within the document but how to deal with these new developments as well.




Arun Rangamani
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Bob Abrahamson
Vice President, Product Management

David Hom
Chief Evangelist

Dr. Kevin Keck
Chief Medical Officer

Jen Cressman
Vice President, Professional Services

John Pagliuca
Vice President, Life Sciences

Jonathan Niloff, MD (Guest Author)
President, Niloff Healthcare Strategies, LLC

Lalithya Yerramilli
Vice President, Analytics

Lesli Adams, MPA (Guest Author)
Director of Population Health Strategy, Oracle Corporation

Leslie Strader
Project Manager

Linda Pantovic (Guest Author)
Director of Compliance & Risk Adjustment, Scripps Health Plan Services

Mark Feeney
Life Sciences Consultant

Monique Pierce
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Rodger Smith
SVP, Payment Integrity

Rose Higgins
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Subha Vaidyanathan
VP, Technology and Data Management

Taryn Bevilacqua
Compliance Director

Tom Peterson
SVP, Risk Adjustment


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