Planwatch Highlights

This powerful, on-demand, web-based tool for health plans, hospital systems, insurance companies, TPAs, HMOs, and Medicare/Medicaid payors examines historical, current, and future health plan dimensions, identifies cost drivers, and provides tested solutions to minimize expenditures. Planwatch is extremely affordable and fully supported with service, expertise, and 24/7 monitoring.

• Allows data exploration down to the most detailed level
• Provides model plan modifications for individual or multi-plan offerings, and/or options for multi-tier benefit structures
• Evaluates health plan economics by readjudicating historical claim sets and providing comparative data
• Connects medical and prescription information by claimant to facilitate the evaluation and monitoring of a participant’s diseases and conditions
• Details medical/prescription patterns and utilization down to EOB level
• Protects health plans by illustrating costs by group or participant
• Separates user access and permission rights by business line segment (self-funded, fully funded, Medicare, HMO, etc.)
• Delivers user-defined capabilities for product functionality to accommodate various business line segments
• Analyzes medical, prescription, dental, and vision benchmark plans and employee costs by procedure category, plan, place of service, SIC code, coverage area, age group, region, network, group size, gender, and enrollment type
• Isolates costs for industry mandates and other state-imposed requirements
• Simplifies PCORI fee filing and calculation
• Data can assist with vendor fee calculation and payment
• Provides branded, customized, full-color reports in high-resolution PDF and Excel formats