WC Claims Processing Solution Saves Millions in Medical Costs
December 21, 2024

Who doesn’t want to save on workers’ comp medical costs? At Acrometis, our comprehensive and adaptive processing solution, CLAIMExpert, eliminates a significant number of medical payments and the associated expenses ahead of the bill review process.

CLAIMExpert ensures only valid medical bills associated with the claim are passed on to bill review for re-pricing. Our clients currently see about 32% of submitted billings returned to the providers as inappropriate, incorrect, or improperly documented, or due to rarity and unrelatedness/causality issues.

What’s even more impressive is that 58% of these returned bills are never re-submitted for processing by the providers!

You might be wondering how CLAIMExpert does it. Think of it as a defect-resolution process on an assembly line, with each bill getting properly assembled and QA’d before it reaches the bill review repricing process. This is significantly different from a traditional bill review process where there is no real process to determine “if” the bill should be re-priced in the first place.

Our solution creates a highly auditable workflow and greatly increases speed and accuracy in the claims-handling process through workers’ comp-specific document handling and rules-based processing built on over a decade of experience in processing tens of millions of workers’ comp claims documents.

CLAIMExpert is a SaaS-based workers’ comp claims-processing platform that integrates with existing claims systems and partner connections to control your medical spend and streamline your claims handling process. You don’t have to find capital for software licenses, consulting fees, or system integration costs. Once CLAIMExpert begins processing incoming claim documents, you only pay a per-document fee. Acrometis keeps CLAIMExpert current with jurisdictional changes, enabling your operations to always maintain compliance.

CLAIMExpert lets you easily add partners into your system with minimal IT resources, already in short supply in your organization. With CLAIMExpert, you can easily try new provider networks in specific jurisdictions, or even zip codes. You can even add alternate backup vendor systems without impacting the rest of your operations.

All of this is based on our experience of generating real and substantial medical savings for our CLAIMExpert clients every day. The best part is that CLAIMExpert by Acrometis is proven to generate real medical savings while working in harmony with your current bill review and mailroom processes.

Acrometis offers the most complete and automated claims processing platform on the market designed specifically for the workers’ compensation industry. The extensive expert ruleset and experience of our implementation team means you could be using CLAIMExpert in just 90 days. This team connects CLAIMExpert to your business and tailors it to fit your business, mapping your current systems, partner connections, and business processes. Then, we integrate that information with our 10,000-plus expert rules, configuring CLAIMExpert to your specific needs.

In short, CLAIMExpert allows you to drastically improve medical savings results while leaving most bill review and mailroom processing in place as it is today. It’s a real win-win!


To learn more about how we can streamline your claims operations and to request a CLAIMExpert impact analysis for your organization, call 1-855-282-1476 or visit Acrometis.com today.

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