AMS (Advanced Medical Strategies)
Focused solely on the most expensive and complex claims, AMS’ AI-driven platform forensically identifies, financially analyzes, methodically predicts and clinically evaluates treatment appropriateness. By turning raw claims data into actionable intelligence, AMS empowers payers to effectively manage their plan and project risk. Payers leverage the AMS Predict Suite: PredictDx (complex diagnoses), PredictRx (specialty drugs) and PredictIx (implants + devices), to evaluate clinical appropriateness and financial benchmarks for the drivers of high-cost claims. Additionally, our FACS claim surveillance module leverages over 10,000 questionable claims flag combinations to deliver enterprise-wide payment accuracy & strategic intelligence to guide business decisions that impact immediate, short-term and long-term initiatives.