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Clinical measures use the administrative or hybrid data collection methodology, as specified by NCQA. Administrative data are electronic records of services, including insurance claims and registration systems from hospitals, clinics, medical offices, pharmacies and labs. For example, a measure titled Childhood Immunization Status requires ...
At the heart of the prudential Solvency II directive, the own risk and solvency assessment (ORSA) is defined as a set of processes constituting a tool for decision-making and strategic analysis. It aims to assess, in a continuous and prospective way, the overall solvency needs related to the specific risk profile of the insurance company.
Analysis: the process of translating data into information utilized for an application. Each aspect is analyzed with 10 different data characteristics: Accuracy: Data are the correct values and are valid. Accessibility: Data items should be easily obtainable and legal to collect. Comprehensiveness: All required data items are included. Ensure ...
This applies primarily to term life insurance policies. Ladder: Ladder offers term life insurance policies without requiring a medical exam for coverage amounts up to $3 million. Applications for ...
The company uses proprietary data sets and industry expertise to provide predictive analytics and decision support consultations in areas including fraud prevention, actuarial science, insurance coverage, fire protection, catastrophe and weather risk, and data management. The company was privately held until an initial public offering on ...
There are two main types of life insurance: term and permanent. Term life insurance is typically more affordable than permanent life insurance because it is only active within a set period. Most ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Key takeaways. Short-term life insurance is a type of term policy designed to cover individuals for a short period of time, often less than a year.
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