Network, Utilization, and Claims Analysis Services

Findley provides data-driven analysis to help our clients better manage their health and group benefits plans. We help our clients navigate and simplify complex issues.

Network Analysis

Findley analyzes networks by providing claims data for re-pricing by competing provider networks to assess discounts and the impact on expected plan costs. We also perform disruption analyses in the event an organization is considering moving to a new vendor and wants to understand the effect on participants as it relates to the doctors and providers they currently use and the size of network that will be available to them.

Claims Analysis

Findley uses ClaimScan® to identify trends, cost drivers, and reasons for budget variances. ClaimScan® provides ad hoc reports on lifestyle related claims, preventive care costs, and employee claims versus dependent claims. 100% of claims are electronically audited to identify overpayments and initiate recovery.

Utilization Analysis

Findley analyzes claims data provided by claims administrators to determine patterns in utilization. Our consultants work to identify changes in plan design and participant communications or the addition of new technologies, such as transparency tools, to help guide participants to making the best choices for the delivery of care.