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.
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
- 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
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.
For more Verisk workers’ compensation compliance solutions, check out:
Provides states and insurers with the means to turn untapped data into actionable insights