Healthcare Intelligence Technology,
Our Most Trusted Claims Management Platform
Our Decision Engine is an essential electronic data interface tool that uses healthcare intelligence technology to determine the most effective way to achieve claim liability reduction. The software platform, the most pivotal piece of our claims management, incorporates billions of dollars in paid claims data and specific algorithms and methodologies to provide our negotiators with the vital information they need to achieve the greatest savings possible.
Claims are filtered into the Consilium Decision Engine through a hierarchy of triggers. These triggers are based on data from the claim, including provider geography and specialty, Medicare reimbursement, geographic usual & customary reimbursement, our history of negotiating with the provider, and more.
With all of this information from the Consilium Decision Engine, our team of experts are able to complete the negotiation process in as little as three to five days.
Our clients’ ROI results are optimized when Consilium is used as the first-tier solution for out-of-network claims. However clients can leverage the Consilium Decision Engine analysis at any point in the claims management process to maximize savings.
Learn more about the claims services we are able to provide using our unique claims management platform.