The PREDICT Platform

The foundation our proprietary solutions, PREDICT is a cloud-based platform that transforms raw claims data into cost-controlling intelligence and risk-mitigating insights.

Predict your biggest risks and liabilities

In millions of members, just a small percentage have the greatest impact. Our automated, AI-driven platform gives you the power to stay ahead of the complex claims and costly reimbursements that those 5% of patients produce:

Forensically identify high-cost members with the biggest potential impact on your plans or business.
Financially analyze their claims for payment accuracy and/or financial risk.
Clinically evaluate those claims for treatment appropriateness and lower-cost alternatives.

Predict your biggest risks and liabilities

In millions of members, just a small percentage have the greatest impact. Our automated, data-driven platform gives you the power to stay ahead of the complex claims and costly reimbursements that those 5% of patients produce:

Forensically identify high-cost members with the biggest potential impact on your plans or business.
Financially analyze their claims for payment accuracy and/or financial risk.
Clinically evaluate those claims for treatment appropriateness and lower-cost alternatives.

Spot these members’ cost-driving claims

PREDICT is purpose-built to zero in on the highest-cost events, prescriptions, and procedures.

Catastrophic diagnoses

Identify the 2.2% of claimants who generate 23% of total reimbursements.

Specialty drugs

Pinpoint the 2% of total prescription volume that accounts for 50% of total drug spend.

Implants & devices

Track the procedures and products that drive ~6% of medical costs – over $175 billion annually

One platform, three powerful solution sets

Payment integrity
Risk management
Business intelligence

Accelerate savings with automated payment accuracy solutions

With PREDICT-based payment integrity tools, you can streamline the process of intercepting specialty drug claims, inflated implant charges, clinically inappropriate or unnecessary treatments.

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Predict and plan for potential high-cost claims

Automate your risk management requirements with clinical insights and financial analytics focused on the biggest cost-drivers in your customers’ and members’ market.

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Get data-driven insights to strengthen your contracts and policies

Leverage up-to-the-minute data from across the market to sharpen negotiations, inform policy decisions, and optimize the cost of care your cover.

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Since Day 1, we’ve made it our mission to make healthcare more affordable, efficient, and effective for everyone. Ever since, our clinical experts, technologists, data scientists have been united and inspired by that one pursuit.

What powers PREDICT:

warehoused claims

0 B

propriety nanoscripts

> 0 K

implant price points

0 M

searchable pharmaceuticals

> 0 K

modeled chargemaster prices from >4K hospitals

0 K

health plan prices across 50K networks

2 T

One-dimensional analytics? Not for today’s healthcare.

One-dimensional analytics?
Not for today’s healthcare.

Health plans, claims managers, and risk entities are racing to stay ahead of unprecedented new pressures and challenges. At AMS, we knew PBMs, cost containment vendors, and conventional analytics couldn’t keep up. So we built a cutting-edge platform that could.

Built on best-in-class data models and powered by standard-setting algorithms, PREDICT delivers the versatile, multidimensional analytics modern businesses need to manage their most complex claims, risks, and business strategies.

One comprehensive solution that spans your enterprise

Ready to spend less time integrating outputs from single-use solutions, and more time advancing business-critical initiatives? PREDICT combines an unrivaled array of analytical tools, reporting capabilities, and data resources in a single platform.

PREDICT Platform

PREDICT Platform

The PREDICT Platform

Predict your biggest risks and liabilities

Predict your biggest risks and liabilities

Spot these members’ cost-driving claims

Catastrophic diagnoses

Specialty drugs

Implants & devices

One platform, three powerful solution sets

Accelerate savings with automated payment accuracy solutions

Predict and plan for potential high-cost claims

Get data-driven insights to strengthen your contracts and policies

What powers PREDICT:

One-dimensional analytics? Not for today’s healthcare.

One-dimensional analytics?
Not for today’s healthcare.

One comprehensive solution that spans your enterprise

Payment intelligence

Network performance

Predictive analytics

Network contracting

Member reporting

Clinical intelligence

Financial analytics

Specialty drug updates

Trust PREDICT to protect your data

This best-in-class privacy, security, and compliance certification applies to all solutions built on our proprietary platform.

PREDICT Platform