Clinical Intelligence, Predictive Analytics, and Reporting

Our Verisk Health unit offers web-based tools for healthcare risk management, analysis, and reporting. Customers include healthcare payers, provider organizations, government entities worldwide, and employer groups. Verisk Health products and services help you identify, analyze, and minimize healthcare risk while containing costs and improving the quality of care. Verisk Health also develops modeling software to predict medical costs and help improve the financing, organization, and delivery of health services.

Risk Adjustment and Predictive Modeling

SightlinesTM DxCG® Risk Solutions
A risk-adjustment and prediction engine for analyzing and quantifying both financial and clinical risk

Risk Management, Reporting, and Analytics

Sightlines Medical Intelligence
Data analytics, clinical intelligence, and benchmarking

Cohort Manager
An Explorer Suite add-on that lets clinicians track population cohorts and evaluate the effectiveness of care-management programs through cost and quality metrics

Sightlines Enterprise Analytics
A flexible, customizable enterprise-level platform for reporting and distributing data through the web

HEDIS Compliance and Reporting

Sightlines Performence Management
Tools for calculating HEDIS® measures, creating and submitting reports, building custom healthcare quality measures, and translating data to required formats

Fraud Prevention

Our HealthCare Insight (HCI) unit offers services that help private and public-sector healthcare claims payors detect fraud, abuse, and overpayment — and avoid ever paying improper claims.

HealthCare Insight® 

Services that help private and public-sector healthcare claims payors detect fraud, abuse, and overpayment — and avoid ever paying improper claims

PhysicianClaim Insight® 

A service that helps prevent fraud, abuse, and overpayment for professional healthcare claims

FacilityClaim Insight® 

A service that helps prevent fraud, abuse, and overpayment for professional healthcare claims

DentalClaim Insight®

A service that helps prevent fraud, abuse, and overpayment for dental claims

PharmaClaim Insight® 

A service that helps prevent fraud, abuse, and overpayment for integrated pharmacy and medical claims

For more information . . .
. . . about Verisk Health products and services, visit the Verisk Health website. For information about HealthCare Insight products and services, visit the HCI website.