Improving Member Outcomes
We Don’t Just Manage Risk. We Transform It.
Improving Member Outcomes
We Don’t Just Manage Risk.
We Transform It.
Kinetiq Health is powered by a multidisciplinary team of in-house clinical professionals, including registered nurses, clinical pharmacists, health data analysts, registered dietitians, a licensed clinical social worker and certified wellness coaches. They are problem-solvers who proudly serve as advocates for our clients, lowering health care costs and improving lives. Together, we provide prescriptive strategies for managing health care risk.
Medical Claims Surveillance
Why Proactive Risk Management Matters for Your Bottom Line
Data-Driven Plan Insights
Why Proactive Risk Management Matters for Your Bottom Line
Health Care Risk Identification
Why Proactive Risk Management Matters for Your Bottom Line
Medical Claims Surveillance
Why Proactive Risk Management Matters for Your Bottom Line
Data-Driven Plan Insights
Why Proactive Risk Management Matters for Your Bottom Line
Your clients gain comprehensive insight into their plan, which allows for targeted strategies to contain risk and cost.
Health Care Risk Identification
Why Proactive Risk Management Matters for Your Bottom Line
Intervenable Moments
from Insights to Action
We leverage claims surveillance data to actively address the areas of risk that cost employers the most—medical and pharmacy benefits claims. Our clinicians activate strategies earlier to ensure the member gets the right care and service at the best cost.
Learn how we do it.
Intervenable Moments
from Insights to Action
We leverage claims surveillance data to actively address the areas of risk that cost employers the most—medical and pharmacy benefits claims. Our clinicians activate strategies earlier to ensure the member gets the right care and service at the best cost.
Learn how we do it.
Second Opinion Review
We engage our proprietary partnership with Mayo Clinic to provide a second opinion review, ensuring the employee’s diagnosis and treatment plan are correct.
Case Management Activation
We activate carriers’ case management resources to ensure appropriate site, cost and quality of care.
Cost-of-Care Negotiation
We negotiate with current providers of high-cost, ongoing medications to reduce the cost of care.
Rx Claims Processing Assessment
We evaluate whether medication costs will be lower if the drug claims are processed as a pharmacy benefit or medical benefit, and work with the medical carrier and PBM to change adjudication, if appropriate.
Provider Identification
We can shift member care to an alternative, geographically nearby provider to reduce the cost of care for employees who require infused medications.
Member Education
We continually review claims data to identify any types of claims that may be increasing and provide employees with actionable insights from our on-staff clinicians to proactively avoid or reduce medical issues in these areas.
Wellness & Mental Health Resources
We provide customized wellness resources to improve the health, engagement and productivity of an organization’s plan members. These include one-on-one health coaching, manager mental health training, health assessments and education for informed lifestyle decisions.
Risk Identification
Unlike most carriers who only analyze claims that surpass the specific deductible, we review all member claims that surpass $10,000 in a single month. Kinetiq Health clinicians review the claim report data and identify an intervention strategy to lower costs or avoid additional costs. Using a risk stratification process, we categorize claims from one-time accidental claims to continuing critical health challenges like cancer.
Let’s talk about what we can prevent next.
From second opinions to cost-of-care shifts, Kinetiq Health turns data into action—reducing risk, lowering costs and improving outcomes for your plan and your people.