Health Care Informatics, Healthcare Modeling | Verisk Health

Verisk Health Resources

Brochures

Corporate Overview

View our complete suite of data-driven solutions and see how they...
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Fraud Finder Pro

Leverage the fraud detection and prevention solution that yields ...
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PhysicianClaim Insight

Learn more about how our claims editing solution can help to improve...
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ACO Reporting

Building from our exceptional track record as an NCQA-certified HEDIS...
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Data Validation

Filter your data for more accurate RAPS submissions.
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DxCG Intelligence

Experience the industry standard in risk adjustment and predictive...
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STARS Solution

Discover how our STARS Solution can help improve your rating and care...
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Reporting & Analytics

Turn analytical insight into action with our Reporting & Analytic...
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RAPS & Encounter Data Submission

Run successful Medicare Advantage and Medicaid programs by leveraging...
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Premium Reconciliation

Ensure correct payment for each member with our Premium Reconciliation...
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Prospective Health Assessments

See how our proprietary Health Assessment Form covers all aspects...
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Nucleus Technology

An atomic change. A universe of difference.
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Medical Record Retrieval & Review

Capture additional revenue while strictly adhering to CMS guideli...
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Medical Intelligence

Download our brochure and gain insight to drive more cost-effective...
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Provider Intelligence

Understand risk, cost, and performance across entire patient panels...
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Case Studies

Humana: Their Fight Against Fraud

For nearly 50 years, Humana has provided full-service benefit sol...
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Helping Employers Lower Medical Costs

Verisk Health helps employers to lower medical costs, improve health...
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Verisk Health Methodologies

Verisk Health's methodologies used in the selection of 80 diseases...
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Corporate Care Management

Drive impactful and cost-effective population health management p...
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Predictive Modeling

See how in an era when healthcare costs are swelling 10 to 15% per...
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Midwest Health Plan

Learn how we improved Mid West Health Plan's ranking from 42nd to...
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First Service Administrators

See how we helped create dramatic reductions in medical and drug ...
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Strategic Benefit Solutions

Benefit Advisory Company Streamlines its Business
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Core Management Resources

Dramatic Decreases in Per Member Per Year Costs
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CoreSource

Facilitating Member Behavior Change Lowers Costs
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White Papers

The Truth Behind Off-Label Drugs

In July of last year, GlaxoSmithKline agreed to plead guilty to what...
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Four Keys to Combatting Fraud, Waste and Abuse

As the fight against fraud, waste and abuse continues, there are four...
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Solving $400 Billion Problem of Fraud in Medicare & Med...

The four keys to addressing fraud, waste and abuse in Medicare & ...
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Medicare Risk Adjustment DxCG vs. CMS-HCC

The Center for Medicare and Medicaid Services (CMS) implemented a...
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Risk Adjustment and Predictive Modeling in Pediatric Po...

Children are distinctly different from adults in both the types of...
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SOA Risk Adjustment Study

Read how in this updated 2007 risk adjustment study, “A Comparative...
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Medical vs. Pharmacy Risk

A key differentiator among product modules in our DxCG Risk Solutions...
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Likelihood of Hospitalization

In order to improve health quality while reducing the cost of care,...
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DxCG Medical Classification

The DxCG Medical Classification System was initially developed to...
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Performance of Risk Adjustment

There are two fundamental categories of models used to quantify clinical...
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Disease and Treatment

Health status and life expectancy reflect a nation’s demographic,...
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Encounter Data Papers

The CMS Encounter Data Submission (EDS) mandate states “CMS is not...
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Profiler Magazine

Profiler 9

In this issue we examine fraud, waste and abuse from every angle.
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Profiler 8

In Issue 8 we focus on improving your healthcare performance during...
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Profiler 7

We look into the various ways the healthcare industry can connect...
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Profiler 6

In this issue we turn our attention to the ideas and innovations that...
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Profiler 5

In this issue of Profiler, we look at the Perfect Service approach...
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Profiler 4

Dr. Raymond Janevicius discusses the tactics dishonest physicians...
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Profiler 3

Dennis Smith discusses the steps that individual states and Centers...
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Profiler 2

Dr. Barry Johnson discusses the importance of mobilizing providers,...
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Profiler 1

In this issue, we uncover the essential elements of effective health...
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