Disrupting Claims Management

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Ilan Dorot, Aero-Plan CEO, on a special interview with INSURTECH ISRAEL NEWS, with a sneak peek at the company’s breakthrough service – Radar.care: “Given information on patient’s condition, location, policy terms and quality and cost of available resources, combined with statistic medical data analysis, and compared with classification of cases, the system would be able to estimate claim outcome and suggest efficient patient care alternatives, enabling the insurer to timely direct the patient to optimal care”

ilan dorot

Tell INSURTECH ISRAEL NEWS readers about the new service – Radar Care.

Dorot: Radar.Care is disrupting Claims management for insurers – offering online Transaction Processing, Big Data analytics, cross-network optimization and Real-time Cost Containment.

Radar.Care provides claims managers with decision supportive data, to determine an optimal care path for a Policy Holder in real-time.

Given information on patient’s condition, location, policy terms and quality and cost of available resources, combined with statistic medical data analysis, and compared with classification of cases, the system would be able to estimate claim outcome and suggest efficient patient care alternatives, enabling the insurer to timely direct the patient to optimal care.

Mitigating Medical & Financial Risk – comparing assistance solutions from a medical and cost containment perspective. The provided visibility to global resource availability and real-time decision support will benefit the patient as well as the insurer, improving cost efficiency and time-to-patient by sharing resources. Our predictive algorithm, relying on categorization of claim outcomes, will assist in quantifying medical and financial risks, which is key for insurers when handling claims, as well as feeding back to setting of policy premiums.

Transaction management – Streamlined cloud based data management (medical/logistic /financial)

Liron Beltzer

What are the benefits for insurers?

Dorot: Traditional insurance models are being challenged by growing global risks and consumer expectations for on-demand services at a competitive price.

In this reality the pricing, processing and settling of claims rely on the claims owner’s ability to access and consolidate data from scattered sources – their own claims history, Assistance/TPA partners, network and provider agreements, medical statistics and reimbursement.

Radar.Care’s Technology and unique business logic provide real-time visibility to the availability, quality and cost of global resources, together with crossed-source statistical analysis enabling claim outcome prediction and optimization.

Radar.Care offers an innovative approach, applying Real-time Cost Avoidance, vs. the limited means for cost containment applied by insurers via pre-negotiated network contracts or post-claim repricing.

What is the business model?
Dorot:
The business model is applied per type of user in the marketplace and dependent on the nature of the transaction, volume of transactions per user and more.

Alexandre Houle

Any combination of the following will apply:

  1. Referral fees – Providers of services (medical facilities, medical operators) pay
  2. Cost containment fees – Insurance and Assistance companies pay – a percentage of savings
  3. Case handling / Transaction fees
  4. Software licensing fees
  5. Data licensing fees

 When do you plan to launch it?

Dorot: Radar.Care will be launched in Q1 2021 in North America (US and Canada), offering claim outcome prediction and optimal care recommendation.
During the course of 2021, Aero-plan aims to mass market these services, becoming a global marketplace for Assistance and Medical Services, facilitating an online transaction exchange between Insurers, Assistance companies, TPAs and providers.

 How did Aero-Plan start it’s activity?

Dorot: Aero-Plan’s original activity is in the Medical Transportation field. Aero-plan, commercially launched in 2015, is a B2B marketplace for Medical transportation, serving over 30 leading Insurance and Assistance clients such as Allianz, AXA and AIG with a global network of top Medical transport providers.

Aero-plan is in fact the first vertical Radar.Care is addressing , as part of a suite of services provided to medical case and claim managers within Radar.Care, when they are assessing the medical and financial risk of handling a patient in a certain facility or moving him to a different one.

Aero-plan enables operational efficiency, mapping patients in need of medical transport worldwide and matching to medical transport providers in real-time. This is, in turn, translated to reduced costs and risk for the payer.

 What investments were made in the company?

Dorot: Aero-plan Holdings Ltd. raised $1.25M from private equity by 2019 and is self-sufficient as of the end of 2018.

Key figures in Aero-Plan management

Dorot is a serial entrepreneur with 20 years of international business experience at global corporates as well as innovative startups. Before founding Aeroplan, he held senior Product and Project Management roles at Pelican Networks, Metacafe.com, ECI and Comverse Technologies, specializing in converting business vision and strategy into deployed optimized online solutions. As an entrepreneur, Ilan founded three start-up companies (JobsMiner, 2Tangos and Musicians_app) and a Product, UX and Monetization Consulting Agency, serving clients such as TEVA Pharmaceuticals, Infinidat and Azorim Real Estate.

Aero Plan’s Chief Medical Officer is Dr. Liron Beltzer, MD. Dr Beltzer co-founded Aero-plan after 15 years experience and extensive track record as a flight physician for the leading US based air ambulance providers. Dr. Beltzer served as a Medical Advisor for one of the world’s leading premium travel assistance, cost containment and repatriation logistics company.

Director of accounts at Aero-Plan is Alexandre Houle. Houle is a certified nurse with a B.S. degree in critical care from University of Sherbrooke and clinical experience in the emergency room. He joined Aero-plan in 2016, bringing substantial knowledge and experience as Medical Case Manager & Clinical Review Officer for one of the largest assistance and cost containment companies in North America, where he handled complex medical repatriations and developed an expertise in cost mitigation and risk management at every step of the episode of care.

 

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