A Comprehensive Suite of Web-Based Business Intelligence Solutions

Health plans across the country use MedeFinance to provide intelligence surrounding contract performance, provider practice patterns, provider coding analytics and medical management. The result is actionable data, which will improve medical loss ratio, track financial performance and drive accountability at all levels of the organization. By making claim, membership, medical management and pharmacy data actionable for decision makers on a daily basis, the MedeFinance business intelligence platform is a transformational solution that enables health plans to build a truly data-driven decision making culture based on measurement and accountability.

The MedeFinance OnDemand model combines a hosted IT environment with web-based analytics and a team of healthcare experts to ensure sustainable value for each customer. This software-as-a-service approach is the foundation for a comprehensive suite of business intelligence solutions that address specific challenges in the areas of contract negotiations and medical management.

Provider Contract Analytics Mede’s Provider Contract Performance solution provides a comprehensive business intelligence platform that enables Health Plans  to manage the complex environment and performance of provider contracting. With this solution, decision makers can proactively monitor provider reimbursement and billing practices including: budget to actual performance, service disparities, cost outliers, up-coding and benchmarking, amongst others.

Medical Management Analytics  Medical Management Analytics enables decision makers to proactively monitor service patterns to ensure members receive the most effective care at the best cost. Mede's web-based business intelligence platform provides insight into the services provided with the corresponding coding, charges and reimbursement information. This allows for comparative performance amongst providers, IPAs, and physicians; it also identifies up-coding, quality concerns, and unnecessary outliers.