Medical necessity predictor
Identify non-motivated treatments
Mavera DSS automatically flags treatments that are not medically motivated, enabling health insurers to approve or reject treatments with confidence.
Cost savings
Our customers save millions of euros yearly by avoiding medically unnecessary treatments.
Enhancing patient safety
Surgeries come with risks. By identifying unnecessary treatments, you can decline them or offer alternatives to your customers.
Boost efficiency
The system guides your focus on priority claims and provides detailed insights for each.
Navigating Treatment Approvals:
Cost vs. Cure
The cost of medical treatments is central to the health insurance business. However but the most effective treatments aren’t necessarily the most expensive.
Some clinics suggest surgeries, while others recommend physical therapy. Bear in mind that they are also businesses.
The insurer’s challenge is to decide what treatments to approve or not. The volume of treatment requests makes it impossible to investigate every request, but where to start?
Automatic treatment review
Mavera DSS reviews all treatment requests and suggests an action path: approve, decline, further investigation, or escalate to a medical advisor. This method enables insurers to spot treatments that aren't medically motivated efficiently.
Case management
Get control over each treatment request and associated costs, with all information securely consolidated in one system and the augmented case view feature, you'll gain comprehensive insights into the customer's medical situation.
Optimize collaboration with healthcare providers
Mavera DSS offers a clear overview of your healthcare providers and allows you to define specific guidelines on how the system reviews treatments from that provider.
