wcNavigator
Detect and manage high-severity workers’ comp claims through predictive analytics
Accurately determining workers’ compensation claim severity early is key to controlling claim costs. wcNavigator® uses predictive analytics to help adjusters and claims managers accurately identify claim severity as early as day one.
wcNavigator identifies high-severity workers’ comp claims
40 days sooner than unaided adjusters.
Start-to-finish predictive analytics for better workers’ compensation claims management
Start-to-finish predictive analytics for better workers’ compensation claims management
Let Verisk help bring the power of AI and predictive analytics to your workers’ compensation claims today.
Lighting the path to better workers’ comp outcomes
Discover how workers’ compensation data can provide valuable insights through advanced automation technology for improved results.
Pilot studies show the solution can identify 82% of high severity claims at first notice of loss and predicts claim severity at closure for 88% of high severity claims by day 30.
Early severity detection can reduce workers’ compensation claim costs
Detecting workers’ comp claim severity early can improve outcomes because it allows adjusters to start managing costs sooner. But the signs of claim severity can be hidden deep within injury reports, medication lists, and treatment plans. That’s why wcNavigator uses powerful predictive analytics that draw upon both company and industry data.
What can you do if a claim scores high for severity?
Examine treatment plan to see if high-cost procedures are warranted
Involve home office examiner, peer review, or an independent medical examiner
Give case to senior claims staff and involve claims manager
Faster Severity Detection Vital to Better Workers’ Compensation Claim Outcomes
The warning signs of severity can be discovered as early as day one, enabling cases to be managed better—to the benefit of claimants and insurers.
wcNavigator provides:
wcNavigator provides:
- continual rescoring as new information is received so you can make informed decisions from first report of injury through claims resolution
- rank-ordered severity score drivers that provide insights into the reasons behind the severity score
- the ability to integrate prescription and medical data directly from your PBM and MBR providers
- pharmacy alerts that notify case managers and adjusters when severity-driving prescriptions are filled
wcNavigator ROI = 35:1
By indicating which cases will spiral into complex, costly claims, wcNavigator can yield a 35:1 return on investment.
The best workers’ comp claims solutions stem from an interdisciplinary team
Our team of nurses, lawyers, adjusters, and insurance claims executives lend their decades of experience to our staff of top data scientists to develop powerful predictive claim models. This ensures that wcNavigator delivers advanced analytics designed by claims people for claims people, providing you the insights you need in a manner that can easily fit into claims workflows.
Automate the retrieval of medical information with Discovery Navigator
A cutting-edge that tool utilizes natural language processing (NLP) and offers options for identifying and extracting certain terms within unstructured medical records resulting in expedited file review at a far lower cost than manual review.
$15,000 saved per year per adjuster in medical document review spend with Discovery Navigator. Based on an adjuster paid $55,000 reading 100 pages of medical information in about two hours with model correcting for human error.
For more Verisk claims solutions, check out:
Mastering data compliance reporting requirements for workers’ compensation
Mastering data compliance reporting requirements for workers’ compensation
Workers’ compensation data compliance reporting is challenging; insurers must carefully format and submit detailed claim and policy data to state jurisdictions and data collection organizations. Verisk has solutions for all workers’ compensation compliance reporting needs that will help save time and improve reporting accuracy.
Capturing workers’ compensation claims information with EDI
Capturing workers’ compensation claims information with EDI
Launching Electronic Data Interchange (EDI) reporting initiatives is challenging for states. Precise, cost-efficient intake mechanisms must be developed to accurately ingest workers’ compensation claims and medical data. wcCapture™ is a cost-effective solution for states seeking to initiate EDI reporting or move to a new International Association of Industrial Accident Boards (IAIABC) release.
Achieve full compliance for future medical allocations while managing expenses
Achieve full compliance for future medical allocations while managing expenses
Complying with Medicare’s demands for future medical allocations requires deep knowledge of both medical and legal aspects of injury claims. We have a range of services to help you comply and expertly manage expenses.
Improve general damages assessments, settlements, and liability
Improve general damages assessments, settlements, and liability
Evaluating general damages for injury claims, pinpointing liability, determining fair settlements, and finding subrogation are all vital to effectively managing claims and preserving insurers’ bottom lines. But carriers have been challenged to accomplish these goals while resolving claims as quickly as possible.
Accurate Medicare reporting lets insurers comply with ease
Accurate Medicare reporting lets insurers comply with ease
Section 111 reporting requirements don’t have to weigh down your claims-handling staff. Our robust CMS reporting solution and review services enable insurers to easily fulfill their obligations to identify and report Medicare recipients in claims.
Mitigate compliance costs of Medicare and Medicaid liens
Mitigate compliance costs of Medicare and Medicaid liens
Our team of legal and medical experts has developed a broad range of conditional payment services regarding the U.S. Department of Treasury, Medicare Advantage, and Medicaid to facilitate seamless, worry-free compliance while reducing costs.
Fast-track meritorious claims while improving fraud detection
Fast-track meritorious claims while improving fraud detection
ISO ClaimSearch® is more than the world’s largest database of property/casualty claims—it’s also a robust claims intelligence platform. Its claims-matching technology is an essential first step in fraud detection, and the results can help facilitate fast-tracking. The platform also provides seamless access to integrated claims fraud-detection and investigative analysis tools.