MEDICAL PHARMACY & CLAIMS AUDITING

SCIO® conducts audits to identify incorrect billing and overpaid facility claims and also offers pharmacy claims auditing services. Our full cycle approach to claims auditing focuses on prevention, pre-payment and post-payment. Whether it is a desk audit or an on-site audit, clients can be rest assured that our sophisticated analytics, operational expertise and clinical knowledge will detect, prevent and recover the maximum number of improper payments.

Back to Top

SCIODxMax™ - INPATIENT DATA PURSUITS

Hospital data pursuit, an important component of a health plan’s risk adjustment program, is the most reliable way to track patients and services rendered. SCIODxMax™ is a full-service hospital data collection service for health plans that eliminates missing and under-reported diagnoses codes related to inpatient stays.

Back to Top

SCIOMDMax™ - Closure of Care Gaps

Health plans and providers can now address gaps in care by collaborating and encouraging data transparency. Our services allow clients to engage providers and members with timely interventions to close the gaps resulting in potential savings and improved health and wellness of their patient populations. SCIOMDMax is a prospective end-to-end service for closing care gaps.

Back to Top

SCIOXpert™ Consulting Services

SCIOXpert™ consulting services pinpoint precise recommendations, prescribe actions, and operationalize insights. By leveraging deep clinical, technical and analytics expertise, we deliver insights for a variety of healthcare organizations.

Back to Top

SCIOXpert™ Commercial Analytics

SCIOXpert™ Commercial Analytics is our consultancy division designed to complement our existing products and services. The SCIOXpert™ Commercial Analytics Team will create solutions, tailored to your needs, providing valuable insights on your secondary data.

Back to Top

DATA INTEGRATION & MANAGEMENT

SCIO® has been managing 80 terabytes of data on 100 million members, from 300 million unique claims. We provide data collection, aggregation, integration and management while maintaining accuracy and integrity.

Back to Top

Sign up to receive the latest SCIO news & insights, industry updates, event updates and more, right in your inbox.