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Create individualized plans that exceed patient expectations
The trend toward customer-centric operations, sweeping across most industries today, is also very evident in health and life sciences. Patients have options for care and coverage — and they now expect faster plan onboarding and claim processing, and personalized monitoring and feedback devices.
At the same time, health care ecosystems are becoming highly complex, with many different types of care and device providers. As consumers make their way through these ecosystems, don’t make them constantly reintroduce themselves.
FICO decision management solutions help you pull analytic insights in secure ways from diverse sources to create consumer-centric and disease-specific views. We put the power of decision science in the hands of business users. Working visually, they can create sophisticated engagement strategies for offering more individualized health plans or products and responding faster to marketplace and changes and patient expectations.
Gain more insight into what consumers want and help them find the right coverage.
Advanced analytics, including machine learning and predictive models, can discover health care consumption and payment patterns that suggest ways to improve plans. Intelligent automated processes driven by decision rules make it easy to set up plan policies, and you can use them to create automated eligibility checks and self-serve onboarding.
Take less time to make better decisions.
Intelligent workflows driven by decision rules can automate underwriting for a large percentage of applications, enabling your experts to focus where they’re most needed. Claims processing systems incorporating advanced analytics save money by looking beyond the claim at hand to catch suspicious patterns of consumer or provider behavior over time.
Identify patients at risk for non-compliance and make better decisions on treatment design.
Medication adherence is closely linked with clinical outcomes. As reported by the Centers for Disease Control and Prevention (CDC), one half of US patients stop taking their medications within one year of being prescribed.
Decision rules along with predictive and prescriptive models put intelligence behind leading-edge mobile monitoring devices. With the ability to analyze historical data and user profiles in combination with data streaming from the device, monitoring and measurements can respond in custom ways to each customer’s situation.
Drive growth with well-targeted omni-channel campaigns.
Digital marketing systems let you quickly bring together data from both online and offline sources for targeted, personalized, rules-driven automated campaigns across customer-preferred channels. Decision rules can also enforce regulatory compliance, calculate sales compensation and validate contracts.
Prevent cyberattacks and data breaches.
Given the importance of privacy and security for health information, and the ingenuity of hackers, it’s risky to rely on traditional methods of detection that recognize only known methods (“signatures”) from previous incursions. Self-learning analytics notice abnormal behavior, even if it’s never been seen before, and thus are better able to detect new and changing threats.
We want to help you future proof the next step in your organization’s journey by sharing the lessons FICO experts have learned about building resiliency during tumultuous times. Register below to gain access to our virtual event series.
From April 20 through May 28, FICO will host a series of live webinars sharing best practices and strategies for resiliency in your organization. The topics fall within six tracks including adaptability, digital customer engagement, risk management, operational efficiency, building trust and protecting customers.
Solving your biggest and most complex business problems.
FICO Optimization Community
Realize the promise of advanced analytics and decision management.
FICO Decision Technology Community
The most accurate security rating service to determine the risk profile of any organization.
A high-performance execution platform to power and connect every decision.
FICO DMP Community
Helping healthcare providers proactively take actions to improve adherence levels.
Modern decision management projects are highly complex, involving interactions between process management, user interfaces, and automated decisionmaking. Project success depends on having a clear and complete set of functional requirements...
Drive smarter, precise and consistent decisions across the customer lifecycle, powered by your business users
Data-driven decisions are becoming strategically important to a company’s success at every stage of the customer lifecycle. C...
If there’s anything we’ve learned from our customers, it’s the power of community. Connecting people who use the same technologies to share ideas and discover new and better ways to solve business problems helps everyone reach their goals ...
Client: Medscheme, South African healthcare administrator and health risk management company
Challenge: Update its existing claims management capabilities and improve the agility, efficiency and effectiveness of the system to respond qu...