4Control | More Power

Know it all. Do something about it.

Capitalizing on every opportunity to reduce plan costs and enhance member value requires more than mere visibility into your historical claims data. It requires the ability to actively intervene in real time—before a payment is made.

It begins by being proactive, by putting employers right in the data stream of incoming claims, 4Control makes it possible to address claims issues and opportunities co-adjudication, pre-payment.

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The most direct path to lower plan costs and greater member value.

The Capabilities

  • Apply Active Interventional Analytics

    4Control assesses new incoming claims before a payment is made to identify potentially fraudulent claims and behavioral patterns at the member and provider level.

  • Activate Immediate Change

    Eliminate costs associated with fraud, waste, and abuse, mitigate avoidable episodes of care, and improve quality of life while reducing plan costs.

  • Make Timely Interventions

    Identify subpopulations that would benefit from targeted Disease Management and Wellness programs, and immediately intervene when employees are not adhering to care plans.

  • Preempt Improper Payments

    Claims identified as questionable are automatically routed for investigation, before they are paid and funds become unrecoverable.

control background
apply active interventional analytics
activate immediate change
make timely interventions
preempt improperpayments

The Value of 4Control

Intercept and Prevent Improper Payments

By preempting payment of questionable claims, 4Control instantaneously eliminates unnecessary costs associated with fraud, waste, and abuse.

In the U.S., up to 10% of total annual healthcare spending, or over $200B, is lost to fraud.
Datameer

Mitigate Avoidable Episodes of Care

By immediately identifying and intervening when members are not adhering to care plans, 4Control improves employee productivity and quality of life while also reducing costs.

90% of all healthcare costs are associated with chronic conditions that are often controlled or preventable.
CDC

Make Out of Network Interventions

By identifying members frequenting OON providers, 4Control empowers you to educate employees on the costs of using out of network care and bring popular providers in network.

Out of network treatment results in bills that are 118% to 1,382% higher than what the federal Medicare system is billed.
America’s Health Insurance Plans

Rapidly Impact Population Health

By uncovering employee health needs within your population, 4Control enables you to execute Disease Management and Wellness programs that improve employee wellbeing.

93% of business leaders said employee health has a significant influence on productivity.
Health Enhancement Research Organization

infographic totaling fraud damages

Healthcare: The Cost of Confusion

Totaling the Damages
An Employer’s Guide to Quantifying & Eliminating Fraud, Waste & Abuse

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From Our Blog

 

May 7, 2019

Healthcare’s Up-and-Coming Changemakers

Recent News

 

June 25, 2019

4C Supports Senate HELP Committee’s Efforts to Tackle Rising Health Care Costs & Health-Data Access

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