2. Payer collects information and analyzes
Upon receiving the request from the insured, payer will collect all information pertaining to the patient that may include demographic data, location data, prior treatment data, disease information, policy data, previous claims data, premium data etc. Data integration, cleansing and transformation required to make the data correct and compatible for the analysis will be completed, and preliminary examination and thoughtful analysis will be initiated.
3. Social media integration
In today’s world, social media plays a vital role in brand recognition, assessment of company performance and customer perception. Many, today, choose physicians, providers and medical facilities for their treatment based on references and information taken from social media and online communities. Data from internet and social media can be fed into Text and Sentiment analysis models to extract better insights about patient preferences, and physician and people reviews.
4. Use analytics to find best providers
Analytics algorithms, implemented on the data, will bring out relevant insights. For instance, it will estimate the amount each provider will charge, the provider that the insured would most likely prefer, which category (VIP, Deluxe, Economy etc.) of the treatment the insured will choose. Finally, the best providers will be chosen and listed out based on overall cost, physician recommendation, insured preferences and satisfaction that can be quantified in the form of ratings on the scale of five.
5. Make recommendation
Based on the analytics outcome, the payer will recommend to a patient a set of providers that best-suit his requirement. This recommendation will include the attributes of the providers, users’ ratings and payer’s preference rating etc. Upon receiving the recommendation, the insured person can choose the provider best-suited to his needs.