Catastrophic claims surface too late
By the time an episode is visible as a high-cost claim, the opportunity to steer site of care or route to a center of excellence has usually passed.
Who we serve / Brokers
Price the renewal on
evidence, not a quote
Stop-loss is priced on how well each side can read the risk. Catastrophic claims surface late, aggregate position gets rebuilt after the fact, and every argument about a renewal is assembled by hand from data that already exists.
The problem
What gets
in the way
Aggregate position is reconstructed, not tracked
Knowing where a group sits against its attachment point mid-year requires assembling data that exists in several places and reconciling it by hand.
A quote arrives without its reasoning
Challenging a renewal means rebuilding the analysis from claims data, under time pressure, every year, for every group.
Solutions
What brokers use
PulseSync for
-
Stop-Loss
Six agents track high-cost claimants and aggregate and specific position all year, and carry an early catastrophic warning through to renewal pricing.
See the capability -
Payment Integrity
Large claims are read before they are paid, so what reaches the attachment point has already been checked.
See the capability -
Utilization & Clinical Review
High-cost episodes are reviewed against the clinical record, and every determination cites it.
See the capability
Every capability runs on the same platform, built from the same skill library and governed the same way, so adding one means new agents on a platform you already run, not a new vendor. See the platform
Next step
See it on your
own data
We run your historic records through the agents and show you what each one finds, with its evidence, before anything is switched on.