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Diagnostic Risk Score
A MedMetrics Medical Management Power App!
 
Diagnostic severity is a reliable indicator of claim risk

The medical diagnosis of an injury is a factor in predicting claim complexity and cost. MedMetrics uniquely assigns severity (medical seriousness) scores to all ICD diagnoses in claims. Diagnostic risk scores are totaled for each claim and recalibrated as the claim progresses using bill review data. MedMetrics continually monitors open claims and notifies designated persons when ICD scores in a claim reach a user-defined set point.

Age and comorbidities are factored into the Diagnostic Risk Score. Now claims adjusters and medical case managers can focus on claims needing the most attention knowing they will be notified when conditions in claims are of concern.

Serious conditions and migrating claims cannot go unnoticed!

Analytics-Informed Medical Management-elegantly simple, yet powerful!



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