ikaPROVIDER360

Consolidated data, delivered seamlessly.

med-arrow

ikaProvider360 delivers a one-stop analytic view of provider information to improve quality while managing the cost of care more effectively. The rapidly implemented, highly configurable solution provides actionable information that enhances a health plan’s ability to develop networks, contracts, prospective quality of care initiatives, and pay-for-performance programs.

ikaProvider360 is a unique analytics solution for health plans that want a single, consolidated view of provider data and performance—including preventive health outcomes, provider versus plan performance, auto-authorization and claims auto-adjudication rates, and cost index and average risk scores versus plan averages.

Flexible and low-maintenance

ikaProvider360 provides a concise view into provider performance via a flexible platform you can implement and maintain cost-effectively. The solution can be seamlessly integrated with any ikaSystems solution or used as a stand-alone solution with legacy systems. As updates become available, ikaProvider360 can be automatically upgraded with little additional effort.

As market demands and business needs evolve, you can easily configure the system without changing any code. This flexibility allows you to update existing plans, products, and networks yourself, significantly reducing maintenance costs.

The benefits speak for themselves

ikaProvider360 enables you to:

  • View a provider’s demographic, operations, and comparative performance data in a single screen—including appeals, claims, and call center records; Medicare risk scores; PMPM average costs; case mix index; profit and loss; BPCI analytics; ACO analytics; P4P tracking; gaps in care; and activity and correspondence logs—or any other provider information your health plan chooses
  • View and drill down on data, including provider versus plan performance, provider panel preventive health outcome statistics, provider operational results such as claims auto-adjudication and auto-authorization approval rates, and cost index and average risk scores versus plan averages
  • Customize drill-down capabilities for all metrics so you can identify issues and take action to improve performance
  • Better support campaigns to address gaps in care, HEDIS®, Stars, and proactive care
  • Design specialized limited networks, contract rates, pay-for-performance programs, and other cost-management initiatives based on accurate, historical provider data
  • Audit data via automated tracking, saving, and time-stamping of each update
  • Increase provider satisfaction by using objective data to make provider network decisions
  • Easily integrate with a call center solution for maximum value

View other products in Medical Management and Analytic Solutions

ikaMember360
ikaHEDIS/ikaProHEDIS
ikaDWH
« Back to Modular Solutions