Fast-track Claims and Utilization Reviews with AI for Better Outcomes at Lower Cost
An automated data analytics solution to inform your workers’ compensation decisions with a unified source of all guidelines, harmonized medical terminology, and AI-driven insights.
Contact Us
Authorize Treatments From a Single Source of All Guidelines
Case managers can now pre-authorize and approve treatments based on the applicable state and evidence-based guidelines from a single repository, updated in real time. Eliminating the time and the effort to search multiple sources of guidelines, Claim Clarity simplifies the process to review cases and approve treatments instantly.
Accurately Define Injuries to Instantly Find the Required Treatments
Your team does not have to be medical experts to correctly define an injury. Simply enter your description in your own words to find the necessary treatment. Claim Clarity’s semantic modeling engine has codified all data to align the underlying concepts and attributes of the search terms with universal ICD and CPT codes. The system automatically matches unstructured descriptions with harmonized data to approve treatments for more efficient claims and effective outcomes.rnrn
Make Informed Decisions with Prescriptive Insights
Claim Clarity is driven by a powerful AI engine that assists with decisions in those cases where recommended care deviates from guidelines. Based on analyses of millions of historical precedents and outcomes, AI approves treatments or diverts outlier cases for reviews, giving users the confidence they need to make informed decisions.rn
Claim Clarity is a trusted partner of ODG
Authorize Treatments From a Single Source of All Guidelines
Case managers and claims adjusters can now instantly pre-authorize and approve treatments based on the applicable state and evidence-based guidelines from a single repository, updated in real time. Eliminating the time and the effort to search multiple sources of guidelines, Claim Clarity simplifies the process to review cases and approve treatments instantly.
Learn more
Accurately Define Injuries to Instantly Find the Required Treatments
Your team does not have to be medical experts to correctly define an injury. Simply enter your description in your own words to find the necessary treatment. Claim Clarity’s semantic modeling engine has codified all data to align the underlying concepts and attributes of the medical conditions with universal ICD and CPT codes. The system automatically matches unstructured descriptions with harmonized data to approve treatments for more efficient claims and effective outcomes.
Learn more
Claim Clarity supports workers’ compensation treatment decisions by connecting an injury description to harmonized medical terminology, applicable state and evidence-based guidelines, and AI-driven insights. When recommended care aligns with guidelines, users can move forward with greater consistency; when care deviates, the system identifies the case for review.
Claim Clarity is driven by a powerful AI engine that assists with decisions. Based on analyses of millions of historical precedents and outcomes, AI approves treatments or diverts outlier cases for reviews, giving users the confidence they need to make informed decisions.
Learn more
A fully automated solution that maximizes productivity and improves claims outcomes for providers and payers
| Solution area | Primary focus |
|---|---|
| Claims Administration & Management | Complete claims with greater accuracy and efficiency. |
| Utilization Review & Management | Determine safe and effective treatments that help employees return to work faster. |
| Bill Review & Management | Lower costs and accelerate payments through streamlined processes. |
| Workers’ Comp Data Analytics | Transform data into actionable insights to improve outcomes. |
Claims Administration u0026 Management
Complete claims faster with maximum accuracy and efficiency.
Utilization Review u0026 Management
Determine safe and effective treatments to return employees back to work faster.
Bill Review u0026 Management
Lower costs and accelerate payments with streamlined processes.
Workers’ Comp Data Analytics
Transform data into actionable insights and improve outcomes.
Transform Your Business with Strategic Consulting Services
Claim Clarity’s AI solution provides untapped opportunities for payers, providers, administrators, and government organizations to transform their data into actionable insights. Working closely with your team, Claim Clarity will analyze your claim and case management operations and provide strategic consulting and technology solutions customized to your unique business needs.
Partner with Claim Clarity for improved outcomes, increase profitability and grow your business.
Contact for consulting services
As featured in:
