Stephens Technology Group provides integrated data management to the health insurer industry with services that include:

• Fraud detection - Searching for claims where the service has not actually been provided. Looking for patterns that would suggest further inquiry into the claim.
• Abuse detection - Searching for patterns indicating that certain providers are performing unnecessary procedures, prescribing expensive medication where a less expensive drug would be as effective, performing unnecessary tests and keeping a patient in the hospital longer than necessary.

Blue Cross

• Analysis of claims
• Providers analysis
• Reporting to groups, government agencies, trade associations
• Analysis of quality of care and costs
• Marketing managed-care contracts
• Financial analysis (actual expenses vs. planned expenses)
• Profitability of manager care arrangements
• Contract performance
• Fraud analysis based on the provider’s health care specialty and the geography of the claim

Pharmaceutical Insurance

• Sales and marketing
• Provider profiling
• Government reporting
• Utilization
• Claims
• Actuarial
• Integrating pharmaceutical information with medical claims
• Cost analysis by patient demographics and geographical distribution
• Cost analysis by provider, provider specialties and treatment protocols
• Analysis by diagnosis/prescription
• Generic/brand name drug comparisons

Insurance Research

• Claims information