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.

Early severity detection can reduce workers’ compensation claim costs

Icon Early Severity Detection

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.

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.

What can you do if a claim scores high for severity?

Examine

Examine treatment plan to see if high-cost procedures are warranted

Involve

Involve home office examiner, peer review, or an independent medical examiner

Case

Give case to senior claims staff and involve claims manager

Faster Severity Detection Vital to Better Workers’ Compensation Claim Outcomes

Faster Severity Detection

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.

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wcNavigator provides:

Wcnav 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

Wcnav Roi

By indicating which cases will spiral into complex, costly claims, wcNavigator can yield a 35:1 return on investment.

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The best workers’ comp claims solutions stem from an interdisciplinary team

Team Icon

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.

Automating insights to transform workers’ compensation claims

Automated Insights

Discover how workers’ compensation data can provide valuable insights through advanced automation technology for improved results.

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For more Verisk claims solutions, check out:

Mastering data compliance reporting requirements for workers’ compensation

Wcprism

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

Wccapture

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

Future Allocation Services

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. ISO Claims Partners has a range of services to help you comply and expertly manage expenses.

Improve general damages assessments, settlements, and liability

Liability Navigator

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

Section 111 Reporting

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

Lien Services

Mitigate compliance costs of Medicare and Medicaid liens

The ISO Claims Partners 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

Iso Claimsearch

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.

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Other Ways to Connect

We are available Monday through Friday, 7 a.m. — 9 p.m. US Eastern Time:

  • Chat Now

    Note that password resets and user information are not available through Live Chat or Email. Instead, please call the main toll-free number below.

  • Main Toll-Free: 1-800-888-4476

  • Global Toll-Free: International Access code, then 800 48977489
    When calling from the UK, please dial 00 800 4897 7489