A Better Way to Handle Worker Compensation Claims
Ambit, our light-touch workers' compensation system for insurance carriers, self-insured companies, lawyers, and claims adjusters uses artificial intelligence to improve how worker compensation claims are organized and processed.
AI for Claims processing
Claims processing is complicated. At any point in the process - review, investigation, adjustment, remittance, or denial - numerous issues might cause error or confusion:
Quality Control Problems
Claims processing tasks sometimes require human interaction and manual efforts that are prone to errors.
Claims come in different formats. These varied forms of customer data often complicates automation efforts.
Redundant efforts by those working on a claim are common, and disagreements on the case's facts sometimes arise.
Smart Data Extraction
The documents that make up a Worker Compensation claim typically contain hundreds of pages of unstructured content in a wide variety of formats. Efficiently finding and evaluating information provided within a claim has been a task that has challenged insurance companies and legal firms for years. But not anymore! More than Optical Character Recognition (OCR), Ambit employs sophisticated artificial intelligence technologies to bubble up the data needed to advance the claims process, and to organize the data to make decision-making easier.
Ambit transforms the claims handling process to eliminate rote tasks like filing and frees claims analysts to focus on and assists them with, more value-add activities. This augmented intelligence extends beyond the claims administration process into the legal arena as well. By incorporating the Award-Winning strategy “Breaking The Habit”, Ambit facilitates a claim’s legal evaluation by automatically flagging possible areas of concern, placing claim artifacts in a timeframe-context, and prompting suggested tasks and legal actions to consider.
A centralized repository that eliminates emailing. With Ambit in place to administer and defend litigated and non-litigated workers’ compensation claims, clients can expect increased efficiency and consistency, and an approximate 50% reduction in average total claim costs (medical, indemnity, and allocated loss expenses), claim cycle-time, and associated personnel costs.
Settle Cases Faster
Now process claim documents, extract relevant data, and generate actionable reports in minutes, not hours! Ambit, with intelligent technologies and the “Breaking The Habit” strategy enables law and insurance firms to settle cases faster and save money. Every single document and piece of new mail related to the claim is reviewed instantly. Keep track of important documentary evidence for trial and witnesses.
Easy Document Organization
Organize claim documents effortlessly in a centralized repository with sophisticated search capabilities! Ambit helps you identify the latest, processed, and corrupted files. Classify policy documents, client documents, payroll, and other documents, seamlessly within minutes - including the identification of important and necessary documents that are missing from the claim, or the relevant documents to support any workflow.
Easier & Faster Analysis
Automate analyzing complex data and contexts with Ambit. Generate a comprehensive report detailing case summary, action plan, list of missing documents, and defense suggestions, rapidly, and with minimal effort -- with machine-like consistency in legal knowledge, skill, and thorough analysis. Identify documentary evidence of fraud automatically to assist SIU investigators.
Reduce Human Errors
Lengthy manual processes contribute to a higher frequency of human errors. By reducing the tedium of claim processing efforts, Ambit enables litigation firms to enhance efficiency and improve services with automated calculation and reminders for important legal deadlines. Identify contradictory claim information.
Ease Personnel Issues
Personnel training is faster because Ambit handles or augments many tasks and simplifies file related housekeeping. At the same time, the work of claims adjusters becomes more interesting. The claims and legal staff have more time to devote to higher-level claim settlement tasks or to trial practice.