Claims Analytics
To reveal cost drivers and assess plan efficacy, BKS uses proprietary claims analytics to develop key performance indicators and ROI metrics.
We take an analytics-based approach to claims analysis. By analyzing plan usage, BKS identifies over and under-utilization and opportunities for wellness interventions. Analysis includes the following:
- Average monthly surplus or deficit to funding rates
- Average paid claims per employee and member
- Top claim diagnosis based on amount paid
- Top paid providers based on amount paid
- Total monthly surplus or deficit to monthly claims per employee and member projections and to aggregate claims projections
- Total paid claims broken out by medical and pharmacy providers
