Partners

Industry challenge

Manually reviewing medical records at scale is a huge drain on resources. The U.S. industry spends $3.5B on labor reviewing medical records per year.

The solution

DigitalOwl’s Digital Underwriting Abstract (DUA) automatically analyzes medical documents, including unstructured data and imaged records, creating a completely digital, interactive document.

Business benefits

• Faster review time with our abstract returned in hours versus days
• Improved productivity and scalability by speeding up tasks, freeing up resources, and empowering your underwriters
• Save money by reducing expensive hours manually reviewing medical records
• Focus on the elements pertaining to the case versus sifting through hundreds – or possibly thousands – of pages
• Make decisions more efficiently, effectively, and with greater confidence

Industry challenge

Insurers struggle to access multiple payment providers and technologies to cover their complex needs. Their legacy IT systems make these integrations a long, expensive, and resource-draining process. On top of that, insurers lack the payment know-how and specialist resources needed to optimise their payments system in-house.

The solution

Through one single connection to us, Imburse connects any organisation, regardless of its existing IT infrastructure, to the entire global payments ecosystem. We do all the heavy lifting of connecting to payment providers and technologies around the globe, making it easy, fast and inexpensive to deploy new technologies, for both collections and pay-outs.

Business benefits

• Improve speed-to-market
• Maximise payment options
• Improve customer experience
• Reduce costs
• Access unified reporting and payment analytics
• Traditional integrations are complex, expensive and time consuming. The Imburse solution looks to remove this obstacle of by offering enterprises a single, convenient entry point to the entire global ecosystems of payments.

Industry challenge

Insurance organizations face many payment processing challenges from improving reconciliation efficiencies, reducing policyholder churn and keeping costs low. Add to that the burden of compliance liability, the pressure of ever-changing customer expectations and the need to reduce policyholder churn. The challenges may well seem insurmountable.

The solution

The joint Sapiens and Invoice Cloud solution delivers a streamlined omni-channel payment experience that improves operational efficiencies by simplifying the payment process and increasing self-service adoption. Invoice Cloud’s tight, real-time integration with Sapiens’ industry leading software solutions accelerates reconciliations, while providing a seamless payment process for policyholders. Invoice Cloud provides a simple, secure online billing and payment solution for insurers.

Business benefits

• Rapid personalization of both claims and policy correspondence reduce cycle times by utilizing previously generated templates
• Easy access to a central repository of templates, plus automated data and content prefill document templates, save agents time
• Built-in document preview capability during authoring facilitates a quick turn-around from edit to production

Industry challenge

Used by claims and case managers, healthcare providers, employers, insurance carriers, third-party administrators, managed care organizations, and attorneys, and adopted by more state regulators for state workers’ compensation systems than any other guideline. ODG by MCG’s goal is to help provide you with the right care, return-to-work plans, and job modifications, with the right resources to the right patient at the right time – with minimal waste and streamlined automation where recovery and guidelines align.

The solution

ODG provides unbiased, evidence-based guidelines and technology solutions that support payers, providers, and employers in their efforts to effectively return people to health in workers’ compensation. The clinical guidelines and analytical tools within ODG help improve and benchmark return-to-work performance, set reserves, facilitate quality care (including auto-authorization by CPT-ICD), and assess the level of claim risk for interventional triage.

Business benefits

ODG for Workers’ Compensation solutions include:
• TAO Index (Treatment Analyzer on Outcomes): measures the correlation of each medical intervention with timely return-to-work
• Treatment Guidelines: ODG evidence-based treatment guidelines are designed for clinical practice as well as utilization review and medical management
• Return-to-Work Guidelines: ODG evidence-based return-to-work guidelines and predictive modeling are designed to impact as well as forecast time away from work for prospective
  case/claims management and retrospective benchmarking

Industry challenge

Most insurers today have a highly manual claims process which leads to substantial process costs, lengthy response times and disgruntled customers.
Customer expectations regarding communication are moving in a direction that requires digitization inside of the insurance companies.

The solution

The joint Sapiens and omni:us solution allows insurers either to automate the claims handling process or to suggest “Next Best Actions” to the claim’s processor.
Cognitive and deep data extraction of all incoming documents (structured, unstructured, continuous text, handwriting, etc.) is interpreted and translated into fully contextualized claims scenarios which prepares the ground for an AI-based decision framework for automation and decision support. Our solution minimizes the manual data processing and forms a basis for straight-through processing at scale.

Business benefits

• Process complexity reduction
• Claims decision support for claims adjuster
• Real-time claims status & updates
• Personalized claims experience
• Fast & transparent settlement

Industry challenge

To provide carriers a digital payment network allowing their consumers a fast, frictionless, and secure payment experience.

The solution

With One Inc’s proven PremiumPay® and ClaimsPay® digital payment networks, we provide insurers with the comprehensive insurance payments experience that customers require – fast, flexible, and future-focused.

Business benefits

• Customer Experience-Connect and engage policyholders through an exceptional, expedient, and seamless payment experience
• Digital Engagement-Proactively engage policyholders throughout the premium and claim payments experience.
• Reporting and reconciliation-Reconcile accounts, instantly find discrepancies, analyze and report payment activity.
• Security & Compliance-Remove sensitive payment data from your network and simplify your compliance burden

Industry challenge

Opterrix is a powerful risk intelligence platform that enables insurance carriers to proactively identify, quantify and mitigate avoidable losses. Designed by insurers for insurers, Opterrix leverages the latest advancements in meteorology, data science, AI, and cloud computing to help insurers make better decisions faster and implement proactive strategies throughout the insurance value chain. Insights are available via our single sign-on web application and API access.

The solution

Underwriting: Opterrix is a single source of knowledge that helps carriers measure and manage property-level accumulation and aggregate limits, real-time moratorium declaration and monitoring, and post-event claims management.
Claims: Opterrix monitors complex portfolios in real-time, provides advanced notifications of upcoming weather events, generates claims predictions before FNOL, and offers unparalleled street-level analysis for optimized claims workflows.
Customer Engagement: Opterrix enables insurance carriers to deliver real-time notifications that protect, inform, and interact with policyholders when and where risk mitigation is top-of-mind.

Business benefits

• Prevent binding of high-risk policies and reshape costly accumulations in real-time
• Create a holistic view of loss activity
• Reduce claims cycle times and loss adjustment expenses
• Improve combined and operating ratios
• Increase customer satisfaction and retention