There, behind that stack of documents, is the overworked claims adjuster, toiling away to try to make a dent in the pile. But no matter how quickly she evaluates and processes each file, more keep pouring into her inbox, as they do every day. And so, the pile grows as the adjuster gets burned out and bleary-eyed. Eventually, the adjuster rushes to make headway and mistakes are made. Things slip through the cracks, and you end up paying for things you probably didn’t need to pay.
If you think this overwhelming state of affairs is simply, “the way it is” in the workers’ compensation industry, perhaps you haven’t heard about CLAIMExpert, the industry’s leading claims processing platform, developed by Acrometis.
CLAIMExpert can automatically eliminate 65% of those documents from your adjuster’s desks, shrinking that incoming amount from a full-blast firehose to a trickle. Now your adjusters can actually do their job effectively, and save you money in the process.
CLAIMExpert can auto-adjudicate 65% of documents that come into your claims shop, processing over 130 different document types. A large portion of what gets eliminated is white mail or bills that can be automatically routed, and your adjusters receive the remaining 30% that really needs a discerning human decision. Our process can give adjusters back 40% of their day; Just imagine what they can do with that time.
Documents come into CLAIMExpert first, which identifies them as needing review or not. If they do, CLAIMExpert alerts adjusters so they can take quick and appropriate action. Every action taken by CLAIMExpert or your adjusters is time-stamped and logged for audit purposes. Of the bills and documents that CLAIMExpert rejects outright, 81% are never resubmitted.
The efficiencies and benefits gained with CLAIMExpert aren’t just limited to the success of your adjusters. Our clients have experienced an 11-point reduction in medical loss in the first year after implementation. As time goes on and we finetune our rules to fit your business needs that number can increase even more; some of our clients have seen up to a 31% reduction in loss and LAE.