BeneMed Features

Information is the key to survival and success in today’s changing marketplace. BeneMed unlocks the power of information in a way that is unlike anything you’ve seen, bought or built, empowering your entire organization to make better and faster clinical and financial decisions. BeneMed is the only benefits decision support solution to meet the data complexity, performance and volume demands of large organizations.

BeneMed eliminates the need for IS professionals to respond to decision support information processing requests by offering end users easy-to-use tools, powerful, built-in data management capabilities, and the ability to perform meaningful, ad-hoc analyses “on the fly.” Standard BeneMed data views provide quick, logical insight into data while ad hoc drill downs allow more advanced users to immediately answer questions that arise from analysis. BeneMed employs an open client/server architecture that allows data and system resources to be shared throughout your enterprise.

BeneMed is a comprehensive data warehouse, analytic engine, and suite of applications, providing superior data analysis capabilities for the information needs of medical benefits management, premium optimization analysis, employee, best practices, training, provider networks, financial management, employer reporting, and marketing decision makers.

As part of its extensive feature set, BeneMed includes a case mix adjustment and episode building system that uses routinely collected claims data as input. The resulting clinically homogenous groups adjust for severity by the presence of complicating conditions, comorbidities and other characteristics of employee claims requests that affect resource utilization.

BeneMed offers the capability to:

• Profile Benefits Program, Evaluate carrier performance using accurate and objective measurements. Measure cost effectiveness carrier premium programs. Evaluate and improve the size and mix of your provider network. Compare plan performance to external standards or those developed to suit your needs.
• Provide Comprehensive Statistical Quality Analyses and Provide employer HR groups with access-to-service and quality-of-service information. Use drill down and trending features to reveal the problems behind the statistics. Manage the impact of changes in plan enrollment and stability.

BeneMed benefits include:

• Reduce IS Costs and Implement new rules and processing efficiencies whenever they are needed without any involvement from your programming staff or claims system vendor.
• Enhance Operational Quality, Process provider management issues in an accurate, timely, and consistent manner.
• Achieve Administrative Simplification, Streamlines claims decision making: there are fewer stops along the way, lower suspense rates, and a comprehensive audit trail to document each decision.