FAQs

1. What is APS data extracted? And what’s the “Synodex Data Dictionary”?

Our medically trained teams use our technology platform to extract all data from the APS that is relevant to underwriting decisions.  The data is normalized to conform to a purpose-built data dictionary, in this case the Synodex Medical Insurance Data Dictionary™.

The Synodex Medical Insurance Data Dictionary™ is the first-ever comprehensive data dictionary for life insurance medical underwriting, with full control sets for over 100,000 diseases and impairments, as well as baseline data such as gender, age, smoking status, etc. It is based on several years of extensive research and compilation in cooperation with industry participants including leading chief underwriters and medical directors.

Think of a “control set” as all data components you need relating to a particular disease or impairment to support the most granular risk discrimination. This typically includes disease grading/staging/status, date of diagnosis, age of onset, related diagnostic testing and associated pharmacology.

2. So what’s innovative here?

For the first time ever, APSs can be processed digitally like other digital sources of underwriting evidence, offering endless possibilities for process and product innovation.

Our clients have identified three broad categories of use cases for APS digital data: efficiency improvement; mortality improvement; and portfolio management. (If you’d like to know more, contact us. We’ll take you through the specific use cases).

On top of that, as an institutional asset, the digital data can provide a strong foundation for the development and refinement of complex models and simulations that ultimately enhance competitiveness. Similarly, the data can be used for computational discovery to refine underwriting rules, analyze trends, maintain decision quality, etc.

3. How does an APS.Extract report compare to a traditional summary?

Because our APS.Extract™ reports are renditions of data extracted from the underlying APS, they have certain important advantages over traditional “summaries”:

  • APS.Extract™ reports can be custom-configured, reflecting a company’s specific preferences for how information is presented.
  • APS.Extract™ Reports can be configured to suggest risk ratings, custom categorization, and application of debits/credits/flat extras, etc., all based on the underlying APS data and consistent with a carrier’s underwriting manual.
  • APS.Extracts™ eliminate the noise of the APS and the subjectivity of a summary because quality is not dependent on individuals making judgments.
  • APS.Extracts™ are highly scalable.
  • APS.Extracts™ can be turned around quickly, even for the largest and most unwieldy APSs (including output from electronic medical records systems, or EMRs). And as the industry shifts to EMRs, faster run times means the cost of APS review stays contained.
  • Insurance companies, including a leading U.S. reinsurer, have decided to allow underwriting solely off of our APS.Extract™ reports.

4. What is your time service between receiving an APS and returning an APS.Extract and data?

Typically 24 hours or less.

5. Is there a difference in protective value between an APS and a Synodex APS.Extract™?

A Synodex APS.Extract™ offers at least the same protective value because it is comprised of extracted from the APS. Several of our clients have extensively tested our APS.Extracts™, concluding that they accurately depict the underlying APS. Moreover, because underwriters are under time pressure, they can often do a more thorough assessment with an APS.Extract™, likely improving protective value as a result.

After extensive testing, Reinsurance Group of America (RGA), perhaps the world’s leading facultative underwriter, began encouraging its clients to underwrite based on APS.Extract™ reports and data.

6. How do I get started? And how much will it cost?

Contact us today to get started. The first step will be for us to understand your goals. We’ll then work with you to define an initial service configuration. For qualified insurers, we provide fully variable pricing and we absorb all start-up costs.

7. How do I get the APSs over to you?

It’s quite simple – you direct your APS retrieval vendors to send the APSs directly to us.

8. How do I get the APS.Extract™ reports and data back from you?

We typically deliver via sFTP, providing a single package that includes the APS.Extract™, the underlying APS and the associated XML data and other code sets you require.

9. What choices do I have for report formats?

You can customize both your report format (how it looks) and substance (data displayed, event chronologies, lists, etc.). We will share with you the most popular options.

10. What choices do I have for data?

You can receive data as XML (fully Accord-compliant) or transformed into a proprietary format of your choice. We can include ICD-10, ICD-9 and MIB codes. We also support a host of other industry code sets.

11. What kind of productivity increases are possible here?

Our clients’ productivity improvement varies with integration level. At the lowest integration level, we deliver to you a generic report. At progressively greater levels of integration, we pass the data through a customized rules base that reflects your underwriting criteria and guidelines.

We will provide you with a model showing the productivity improvements you’re likely to achieve at each integration level, and then the decision is yours. A large insurance company performed a study recently which concluded that its underwriters were 2.8 times more productive using our base reports. We expect that carriers will likely achieve 5 times improved productivity with full data integration.

12. How does an APS.Extract™ report and associated XML data improve underwriting effectiveness?

Underwriters typically allocate between 20 seconds and 60 seconds per page to review an APS. That’s not a lot of time to perform a complex review. But a 150 page APS typically condenses down to a 10 page APS.Extract™ report – enabling underwriters to spend their time underwriting, not turning pages.

Underwriting manuals are complex, often requiring underwriters to perform complex calculations and table lookups. We build comprehensive rules sets that enable computers to perform much of this automatically, enabling underwriters to focus on applying judgment and making decisions.

Proof point: in pilot trials, several of our clients have reported underwriting with APS.Extract™ reports and data has resulted in more than three tables revised underwriting.

13. Is it possible for me to license the Synodex data extraction systems for use by my own staff (rather than having you perform the service for me)?

Yes, in fact we plan to announce such a deal with a major carrier prior to the April, 2015 AHOU conference. We would be pleased to conduct a conference room demonstration for you of our platform and discuss how to integrate it within your operations.

14.  What choices can I make in terms of automation?

You can decide how much (or how little) automation you want. Our data and rules are ready to handle the most complex impairments and co-morbidities, and can be used to create alerts, trigger workflow, categorize, assign debits, credits and flat extras, derive ratings, identify declines, etc. We can work “stand along” or can integrate with your existing systems.

The good news is that you can start simple and progress with greater integration and rules-based processing as you are ready.

15. What about information security?

You’re in good hands with Synodex. Our systems and operations are HIPAA and DPA audited and compliant, ISO 27001 certified and SSAE 16 Type II compliant. Synodex utilizes SunGard Managed Firewall and Data Intrusion Services as well as Advanced Oracle Database Security. All data, including data at rest, is AES 256 bit encrypted. Medical records data never leaves SunGard. Synodex and Innodata are on the US Safe Harbor registry. Over 19 carriers have conducted information security reviews, all of which we passed.

16. Do you support electronic healthcare record formats?

Yes. We can obtain data directly from EHR systems. Moreover, we serve on the HL7 standards committee and will continually innovate on your behalf to be sure that you’re prepared to handle the increased volume of data produced by EHR system and incorporate metadata and codes useful for underwriting and claims processing.

17. What other products and services do you have for me?

We specifically configured APS.Extracts™ for life underwriting and life claims adjudication. In 2015, we expect to release a property & casualty (P&C) product and products for the disability income (DI), long-term care (LTC) and health insurance industries shortly thereafter.

Want to discuss further? Become a charter customers for a new product? Need help with other data processing challenges or configuring systems to work with digital data? Contact us today – tell us what you’re up against and let’s brainstorm it together.

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