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Control Claims Costs

REDUCE MEDICAL CLAIMS LEAKAGE AND IMPROVE CLAIMS MANAGEMENT

Workers’ compensation claims are skyrocketing—and so are their costs. Cognizant’s OptimaMedWise can prevent up to 10% in claims leakage.

Workers’ compensation medical costs are rising faster than the medical consumer price index. For insurers, that means claims payments are cutting into profitability, posing a potentially existential threat to the business.

Cognizant’s OptimaMedWise™ can help. With this solution, insurers can take full control of workers’ comp claims management costs, and deliver positive outcomes for members. By bridging gaps between traditional cost containment strategies like medical bill review, nurse case management, and utilization review, OptimaMedWise can eliminate up to 40% of manual claims decisions, reducing your operating costs.

With OptimaMedWise, you can:

  • Review and confirm the medical necessity for all claims, saving unnecessary expense.
  • Provide cost-effective treatment plans for members.
  • Gain evidence-based guidelines for making objective claims decisions.
  • Automate bill processing, saving time and costs.
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Medical Necessity Reviews

All claims are reviewed by our medical experts, who find the claims that are outside the norm and recommend which ones to question.
Treatment Plan Engine

Establish a treatment plan for every claim and update it as needed. Automation provides immediate processing of routine claims and full monitoring of business activities.
360-Degree View

Gain a holistic view of every claim, with details on treatment plans, current status, payments, and medical histories.

OUR PERSPECTIVES

OUR LEADERS

Chris Daniel

Client Services Executive
Cognizant Technology Solutions

BIOGRAPHY


Banwari Agarwal

VP Insurance BPS
Cognizant Digital Operations

BIOGRAPHY


Shankar Balakrishnan

SBU Head, Insurance Digital Operations and Head of Practice Development
Cognizant Digital Operations

BIOGRAPHY


TAKE THE FIRST STEP

Serving customers by looking forward as well as back is a big promise, but the power of today's new digital capabilities is vast and growing.

 Let's talk about how digital can work for your business.

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