The HFBS Health Insurance Solution is three intergrated software modules used to analyse and plan health insurance policies and the coverage of health care services they offer to policy holders. The solution is designed for use by health insurance companies and offers benefits for payers, providers, and patients.
The solution captures all information on an existing healthcare network, and uses this information to: Calculate provider rebate pricing, Identify gaps in network coverage, Plan new health insurance products, and Search health services on a map. The solution is accompanied by professional services and support from health data experts who are available to assist with uncovering insights in your health insurance data.
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The HFBS Provider Scoring Module is designed for health insurance analysts and provider network planners, the module creates a score for a provider based on the coverage of services they offer and their geographical location.
The provider score is a powerful metric that can be quickly used to assess if a healthcare provider’s services are in high demand.
Using this information health insurance analysts can:
– Assess how in-demand a health care provider’s services are inside an insurance network using a range of indicators
– Review geographically where the same health care services may be more or less in demand, offer information to care providers on where there services are most in need
– Analyse the gaps in an existing network of health care providers, plan future changes to a health care provider network, and design new health insurance products
The module’s workflow allows analysts to either analyse existing providers in the healthcare network, and analyse changes to the network to determine what effect they will have on the coverage of services offered to policy holders. The system is powered by a future facing health services data model developed for exclusive use by the health insurance community.
The data underpinning the module contains information on all health facilities in your health insurance network – this is updated through the module and stored in the HFBS Provider Network Module as heath care providers are added and removed from the network, and new health insurance products are created offering specific access to the network.
The HFBS Provider Network Module is a web based solution for storing all information about a network of health facilities and the types of care they provide. The module is used to centralise and store all information on the health care services offered in your Health Insurance products, the system offers access to the data via an intuitive range of visualisation tools and a sophisticated API.
As data is added to the Provider Network Module it influences the scoring and analysis results available in the Provider Scoring Module. Also information stored in the Provider Network Module is made available via the Provider Map Module. In this way information on the health care services offered in your Health Insurance products are always available for analysis and search within the HFBS Health Insurance Solution.
Data stored in the HFBS Provider Network Module is open for use in other software via a secure web service API, information stored in the Provider Network Module is saved securely in an encrypted and backed up database. The HFBS Provider Network Module is trusted to securely store health care information for some of the largest healthcare networks in the world.
The HFBS Provider Map Module is a web based tool used to search and visualise health services offered in your health insurance products, it can:
– Search for detailed information on health care providers by name or by location.
– Show information on various health care insurance plans offered by your company.
– Allow users to analyse and gain insight into health services offered in your insurance products.
The HFBS Health Insurance Solution is available via our private cloud or we can install it for you onsite. For more information please contact us.