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Reduce medical claims leakage & improve claims management

Enable medical necessity reviews of workers' compensation claims at scale.


Create a recommended plan for treatment by incorporating artificial intelligence with evidence-based guidelines

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

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.
View Complete Claims

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

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



Victor Paul

Venture Leader, Cognizant Workers Compensation Care Analysis
Digital Business Operations



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.

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