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CONNECT WITH US:
IT: Customized to Your AdvantageIT: Customized to Your Advantage Public | Copyright © 2017 Prolifics
Specialized Subrogation Capability
powered by
CONNECT WITH US:
Public | Copyright © 2017 Prolifics 2
Agenda
 What is Specialized Subrogation
 What makes us unique
 Our Process
 Who we are
 Our offer to you
 Next Steps
CONNECT WITH US:
Public | Copyright © 2017 Prolifics 3
Subrogation vs. Specialized Subrogation
Subrogation
Subrogation is the right for an
insurer to legally pursue a third
party that caused an insurance
loss to the insured. This is done
as a means of recovering the
amount of the claim paid by the
insurance carrier to the insured
for the loss.
You are doing this today.
Specialized Subrogation
Specialized Subrogation advances the
creation of business value with expertise
in tort law and claims recovery. We
leverage our experts in the field of law,
medical claims and data to ensure we
enhance your current subrogation
process to target pharmaceutical and
medical device injury.
You NEED to do this.
This is a PASSIVE approach This is a ACTIVE approach
CONNECT WITH US:
Public | Copyright © 2017 Prolifics 4
What makes us Unique - Team of experts
Enhancing Claims Recovery – through the deployment of talent & reference data
Prolifics & Cognitive forensics have assembled not only the solution but also a team of medical, legal and
technical experts to develop, enhance and deliver this solution to your company
Medical experts
Identify issues
Medical Team Review
Billing experts
Categorize issues
Assemble codes
Data experts
Create Cognitive Process
Develop Solution
Pull information
Legal experts
Recover claims
Coordinate settlement
Process recovery
CONNECT WITH US:
Public | Copyright © 2017 Prolifics 5
Specialized Subrogation – A process
Executing your data for recovery – step by step
1.
Data Ingestion Phase
2.
Data Relationships
3.
Cognitive Enhancement
4.
Recovery Ranking
5.
Recovery Processing
Data Mapping
Data Modeling
Data Preparation
Party Matching
Historical mapping
Lineage Development
Legal Matching
Data Enhancement
Legal Action Match
Data Statistics
Enrichment Score
Ranking Output
Candidate Select
Legal Action
Tort Inclusion
Every data source is processed and promoted through our 5 stage process to ensure the most confident,
accurate and reliable approach to claim identification & financial recovery
 HIPAA Compliant
 HIGHTEST Compliant
CONNECT WITH US:
Public | Copyright © 2017 Prolifics 6
Who we are – a combination of benefits
Delivering a Unique Value Proposition
Cognitive Forensics specializes in alternative
recovery sources defective drugs and products
supporting healthcare insurance providers. We
augment our client’s subrogation capabilities and
focus on specialization, enhancing your current
capability and maximizing the monetization of your
data. Utilizing advanced analytics Powered by IBM
Watson and legal tacticians with decades of
experience to identify and link unknown claims
associated with defective medical devices and
dangerous prescription drugs..
Prolifics provides deep solution development,
architecture and domain expertise in the design and
deployment of enterprise data rich solutions. We
specialize in developing repeatable solutions for our
clients in healthcare. We are proud to deliver the
solution necessary to combine Cognitive Forensics
high fidelity subrogation reference sources and
innovative technologies to deliver a a trusted match
for cost recovery.
http://www.prolifics.com http://www.cognitiveforensics.com
+
CONNECT WITH US:
Public | Copyright © 2017 Prolifics 7
1. We review our data assessment process
You provide a subset of your information to us (scrubbed or real) information
This can be done onsite with your data in a (clean room)
2. We configure our Subrogation engine to model your information
We will ingest your information and run it through our solution
3. We will walk through our findings with you
We will show you where your data can pay you dividends
Our offer
Easy as 1, 2, 3 ?
This above process is provided at zero cost to your business - let us show you your results
Prolifics Cognitive Subrogation Solution

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Prolifics Cognitive Subrogation Solution

  • 1. CONNECT WITH US: IT: Customized to Your AdvantageIT: Customized to Your Advantage Public | Copyright © 2017 Prolifics Specialized Subrogation Capability powered by
  • 2. CONNECT WITH US: Public | Copyright © 2017 Prolifics 2 Agenda  What is Specialized Subrogation  What makes us unique  Our Process  Who we are  Our offer to you  Next Steps
  • 3. CONNECT WITH US: Public | Copyright © 2017 Prolifics 3 Subrogation vs. Specialized Subrogation Subrogation Subrogation is the right for an insurer to legally pursue a third party that caused an insurance loss to the insured. This is done as a means of recovering the amount of the claim paid by the insurance carrier to the insured for the loss. You are doing this today. Specialized Subrogation Specialized Subrogation advances the creation of business value with expertise in tort law and claims recovery. We leverage our experts in the field of law, medical claims and data to ensure we enhance your current subrogation process to target pharmaceutical and medical device injury. You NEED to do this. This is a PASSIVE approach This is a ACTIVE approach
  • 4. CONNECT WITH US: Public | Copyright © 2017 Prolifics 4 What makes us Unique - Team of experts Enhancing Claims Recovery – through the deployment of talent & reference data Prolifics & Cognitive forensics have assembled not only the solution but also a team of medical, legal and technical experts to develop, enhance and deliver this solution to your company Medical experts Identify issues Medical Team Review Billing experts Categorize issues Assemble codes Data experts Create Cognitive Process Develop Solution Pull information Legal experts Recover claims Coordinate settlement Process recovery
  • 5. CONNECT WITH US: Public | Copyright © 2017 Prolifics 5 Specialized Subrogation – A process Executing your data for recovery – step by step 1. Data Ingestion Phase 2. Data Relationships 3. Cognitive Enhancement 4. Recovery Ranking 5. Recovery Processing Data Mapping Data Modeling Data Preparation Party Matching Historical mapping Lineage Development Legal Matching Data Enhancement Legal Action Match Data Statistics Enrichment Score Ranking Output Candidate Select Legal Action Tort Inclusion Every data source is processed and promoted through our 5 stage process to ensure the most confident, accurate and reliable approach to claim identification & financial recovery  HIPAA Compliant  HIGHTEST Compliant
  • 6. CONNECT WITH US: Public | Copyright © 2017 Prolifics 6 Who we are – a combination of benefits Delivering a Unique Value Proposition Cognitive Forensics specializes in alternative recovery sources defective drugs and products supporting healthcare insurance providers. We augment our client’s subrogation capabilities and focus on specialization, enhancing your current capability and maximizing the monetization of your data. Utilizing advanced analytics Powered by IBM Watson and legal tacticians with decades of experience to identify and link unknown claims associated with defective medical devices and dangerous prescription drugs.. Prolifics provides deep solution development, architecture and domain expertise in the design and deployment of enterprise data rich solutions. We specialize in developing repeatable solutions for our clients in healthcare. We are proud to deliver the solution necessary to combine Cognitive Forensics high fidelity subrogation reference sources and innovative technologies to deliver a a trusted match for cost recovery. http://www.prolifics.com http://www.cognitiveforensics.com +
  • 7. CONNECT WITH US: Public | Copyright © 2017 Prolifics 7 1. We review our data assessment process You provide a subset of your information to us (scrubbed or real) information This can be done onsite with your data in a (clean room) 2. We configure our Subrogation engine to model your information We will ingest your information and run it through our solution 3. We will walk through our findings with you We will show you where your data can pay you dividends Our offer Easy as 1, 2, 3 ? This above process is provided at zero cost to your business - let us show you your results