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Workers Compensation Care Analysis

Sharpen operational visibility by reducing claims leakage

Cognizant Workers Compensation Care Analysis generates a recommended treatment plan for each claim, so your organization can drive medical cost containment at scale. It’s an easy-to-deploy, business process as-a-service solution that automates and expands medical necessity reviews across your claim volume.
Applying artificial intelligence and incorporating evidence-based guidelines, the solution automatically creates a recommended plan for treatment on each claim and compares it to the actual treatment performed. When the system identifies discrepancies, claims are reviewed by a team of clinical professionals. This streamlines the medical necessity review process and reduces complexity, resulting in better treatment for injured employees and lower costs for carriers.
Reduce claims leakage
Reduce claims leakage

By flagging claims that are inconsistent with approved treatment plans and forwarding them for review by health-care professionals, your organization can reduce unnecessary payments.

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View complete claims
View complete claims

Review all your claims in-house, with full details, including current and prior treatment plans, clinical histories and approved medical bills.

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Sharpen operational visibility
Sharpen operational visibility

View business activity monitoring reports to track your medical necessity processes.

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Workers Compensation Care Analysis

Identify non-essential, non-compensable medical services with a common framework based on existing and emerging medical evidence for all types of workers’ comp claims.

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Accelerated pathways to digital transformation in insurance

IDC observes that many innovative businesses are considering SaaS offerings as they help avoid the need for large on premise solutions, complex integration requirements, or expensive and time-consuming customizations. Industry-specific or vertical SaaS offerings are applicable when an insurance carrier wants to bring a specific service to the market quickly with greater cost efficiency, usability, and flexibility.

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Our perspectives

COVID-19: Time for P&C and life insurers to give digital capabilities a tough workout

Exercising digital strengths will help insurers maintain high-quality experiences for policyholders during the pandemic while improving business resiliency.

The insurance AI imperative

Although some companies are investing aggressively in AI to slash costs while also enhancing the customer experience, most insurers will need to accelerate their efforts or risk discovering that it has become too late to catch up.

insurance ai
7 data principles: How insurers can thrive in the coming AI-driven age

Data has always been the lifeblood of the insurance industry, but many companies are struggling to use it effectively. 

Our leaders

Victor Paul

Venture Leader, Cognizant Workers Compensation Care Analysis Digital Business Operations

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.