ASSEC is a self-managed health plan operator registered with Brazil's ANS, with about 5,000 beneficiaries. Its controls were outdated and partly manual, and the new management wanted to bring technological change to the operator.
The Challenge
“The results are surprising, mainly in terms of cost reduction, response time for performance, and almost-instant auditing.”
The Solution
- BI plans for strategy optimization, cost optimization, and fraud detection
- Focus on reducing the loss ratio and closely monitoring providers
- Monitoring of high-cost patients and identification of irregularities
- The OPME Digital tool, to make negotiating the purchase of high-cost materials easier
Results
- Lower costs
- Faster performance response and almost instant auditing
- Short, medium, and long-term planning based on annual diagnoses presented by BIX
