Southeast Management Consulting
Committed to the Success of Your Business
SEMC
NavigatorMD
Phone: (423) 343-5404
E-mail: dforinash@semgmtconsulting.com
To contact us:
Introducing, NavigatorMD Design 180™ software,...the simplest, most comprehensive timely data source and analytical tool available for health plan design and management.
Use the analytical information from your plans claim data to design your health plan and wellness program and measure the results/savings.
Chronic Disease Management (approximately 70% of total claims cost)
Indentify chronic conditions unique to your plan (over thirty predefined conditions) - % of population and claims cost. Immediate measurement of compliance with medical standards of care and cost related to compliance. Quickly/easily identify cost of increasing compliance.
Preventive Screening / Immunizations
Identify compliance with medically recommended screens (i.e. breast cancer, colon cancer, cholesterol, etc.) based on medical guidelines. Identify immunization compliance.
Plan Modeling / Design
Measure the impact of plan design changes on plan cost. In/Out of Network Deductibles, Coinsurance, and Out of Pocket Max. Supports multi-tiered plans. Assign specific coinsurance, deductibles, copays, occurrence limits, dollar limits to specific procedures / benefits
Cost Tracking / Data Analysis
Standard monthly predefined reports – plan summary, top ten procedures, top ten diagnoses, top ten providers etc. Ad hoc analysis and reporting – drilldown capability and exportable to standard PC software
NavigatorMD software is installed locally on a PC. TPA’s transmits raw claims data to NavigatorMD headquarters on a monthly basis. NavigatorMD maps your plans data, through its unique data transformation technology, to an encrypted HIPAA compliant database. Updated databases are easily downloaded to the plan sponsors PC.