The PDF Claims-Based Personalization in Action shows how Benefitsolver activates personalized benefits using claims data. For example, when Matthew, a 51-year-old employee, visits a doctor, his claim generates billing, diagnosis, and procedure codes. The carrier aggregates the data, which MultiPlan ingests into a secure, cloud-based system with continuous analysis. After passing a 30-point quality check, the data flows into Benefitsolver, flagging Matthew as pre-diabetic. This automatically activates engagement tools like a Diabetes Management Program, providing timely support. The process demonstrates how claims-driven insights improve health outcomes, engagement, and benefits utilization.

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