Improve Outcomes with Accurate Insights in Shorter Timelines
Watch your teams close workers compensation claims faster with an automated solution that provides instant pre-authorization and approval based on evidence-based guidelines and AI-powered insights. Developed by workers’ compensation professionals, for workers compensation professionals, Claim Clarity is the essential solution for hyper-efficient and effective management of medical benefits.
Contact for a consultationPerfect the process
for near-perfect claim outcomes
Claim Clarity guides users through the entire claim life cycle, with an automated, simplified workflow, providing a single source of all guidelines, and real-time data analytics. Incident details are automatically standardized for input to ensure the most effective treatments are found. Claim Clarity has codified all ICD codes for injury and incidence data to map them into every part of the human anatomy that pinpoints the exact location, and finds the corresponding CPT treatment codes. This granular level of harmonization ensures near-perfect accuracy of claims.
Another layer is powered by AI, which provides authorization and approval of treatments based on instant reviews of millions of historical cases. Case precedent gives providers and payers the confidence to make decisions with unprecedented levels of accuracy to help injured workers receive the most effective medical care.
Claim Clarity is a Trusted Partner of ODG
Shorten claim response timelines
The automated solution with AI-powered insights guides users, saving hours from every workday. The solution presents a single source of all state and evidence-based guidelines, updated in real time, eliminating the need to search for the right treatment from multiple sources of data. Harmonized coding for all incident and treatment criteria accelerates approvals, reserving manual reviews for only those requests that have no relevant guideline – or historical precedent, after instant review by AI.
Accelerated claims help providers and payers expedite the delivery of medical care for timely return to work.
Reduce costs, improve profitability
Less processing time results in lower costs, as your teams resolve more claims more efficiently. More accurate data eliminates the risk of human error, costly audits, and fewer cases being diverted into unnecessary utilization and peer reviews. Better accuracy leads to better treatments, and lower risk of litigation, ultimately relieving the burden on all stakeholders and delivering savings.
Hyper-boost decision making
Automation in Claim Clarity is about more than streamlining workflows. The solution brings together all state and evidence-based guidelines in a single repository, removing the endless manual effort to search for guidelines from multiple resources. Stakeholders collaborate more effectively through a single source of truth, that translates all input into actionable insights, thanks to the power of AI. Your administrative team does not need to be fluent in medical terminology – Claim Clarity automatically harmonizes their incident and treatment descriptions to codify the response and approval process, empowering your team to improve medical outcomes, leading to better business performance, and stronger compliance.
*Results from a pilot study conducted in partnership with Claim Clarity and ODG with a leading state insurance fund.
Strengthen and Grow Your Business with Strategic Consulting Services
Claim Clarity guides your business to strategic growth by taking advantage of opportunities never imaginable before the advent of AI. Now you can build on the learnings from the vast amount of historical case data. Powerful AI analyzes all claim data to predict outcomes that help your business optimize resources and control costs.
With Claim Clarity AI you can predict the length of time it will take for a specific claim duration, and view the time it will take to return the injured employee back to work. You can view the possibility of the claimant going into short term or long-term disability, and adjust reserve levels to reduce exposure to risk. The possibilities are endless, uncovered by your strategic needs and goals.
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