Redirect members to higher‑performing providers, reduce retreatments, and improve predictability—without changing your network. Launch in ~90 days.
Based on a 2M member plan; refine with your fees & policies during implementation.
We combine claims, eligibility, provider data, and quality signals to produce risk‑adjusted scores and steerage recommendations—then operationalize within your existing tools.
Tiered ranking of dentists per procedure; member‑facing nudges and directory ordering.
Risk‑adjusted outcomes, appropriateness, prevention, and predictability.
Natural‑language analytics for actuarial, network, and member‑service teams.
Early detection of complaint spikes and unusual patterns.
Support value‑based reimbursement and targeted fee strategies.
Executive dashboards, steering committee cadence, auditability.
0–30 Days
Secure data exchange; cohort definition (e.g., crowns, endo); baseline measures.
30–45 Days
Model calibration and provider tiering; internal review with SMEs.
45–75 Days
Directory ranking, navigation prompts, steerage playbooks, comms templates.
75–90 Days
Savings readout, quality checks, stakeholder sign‑off, scale plan.
Cohort example: crowns & endo; ~200k attributed members; estimated savings $5M–$10M annualized.*
*Based on a 2M member plan; refined to your fees, policies, and geographies.
Ranked provider lists, directory ordering rules, and member‑navigation prompts.
Baseline vs. KPIs; savings model with sensitivity; next‑step plan.
Comms templates, provider recruitment targets, governance cadence.
Lightweight. We ingest standard claim/eligibility/provider feeds and overlay on your existing directory and navigation tools. Most implementations start surfacing steerage in ~90 days.
No. We rank and nudge within your current network, focusing redirection toward higher‑performing providers and flagging recruitment opportunities.
We co‑select a high‑impact area (e.g., crowns/endo, preventive, OON leakage) with measurable baselines and clear operational levers.
We set a steering committee cadence, document rules for directory ordering and nudges, and maintain audit trails. HIPAA‑aligned handling and SOC2‑ready practices.
Tell us about your plan and the cohort you want to focus on. We’ll map a 90‑day path to measurable savings and a clear scale plan.
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