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Native AI for your

Workers' Compensation

Claims Administration 

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Why KlearClaims?

THE FUTURE OF CLAIMS ADMINISTRATION IS HERE  - KlearClaims™ - Our SaaS based claims solution with intuitive Native AI POWER! 

Automation

Enhance Efficiency through Automation of Claims Handling for Workers Comp Claims Management

Artificial Intelligence

Leverage cutting edge AI to identify claims which need immediate attention; Enable the system to recommend claims administration

Collaboration

Extend the claims handling program by seamlessly integrating multiple teams into the workflow

Performance Management

​Objectively quantify the accuracy of examiners, the contribution of auditors, and the ROI of the claims handling program to your organisation.

It’s more than just claims software—

it’s peace of mind

KlearClaims Ecosystem

The KlearClaims Ecosystem (Administration, Analytics, Audit, & Intake ) is a modern, unified SaaS platform supporting full lifecycle claims administration with native, AI modeling powering robust Predictive Analytics, Intake and Automated Auditing functionality.  

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Configurable Client Handling Instructions

- Adjuster - 

Automated client handling instructions ( CHI ) for each claim saves adjuster's time handling multiple clients

 

- Supervisor - 

Focus on task’s based on priority for real-time transparency

 

- Executive - 

Highly configurable and customizable unique UI for Clients, Carriers, Line of Business, Claim Type, Jurisdiction and Organization

Integrated AI Supporting Your Claims Handling! 

- Adjuster -

Native AI analytics help adjuster predict claim's severity, litigation & subrogation propensity and reserves, all within the claim system

 

- Supervisor -

AI integrated dashboard unique to each claim summarizes claim's critical activities for quick claim assessments 

 

- Executive -    

Automate claim workload distribution by having multiple employees work on a single claim based on their role ( Role Based Automation )

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Smart, Situational Compliance Automation


- Adjuster -

Distinguished, unique interfaces for Workers' Compensation and Liability optimize claims management workflow

 

- Supervisor -

Automate audit plans “powered with AI” customizable based on client, carrier and state regulations to highlight claims handling performance

 

- Executive -

Real-time pre-validated compliance submissions and carrier reporting to avoid late fees and penalties

Frequently asked questions

As a KlearClaims™ prospect, what does native AI mean for me?


The KlearClaims Ecosystem (Administration, Analytics, Audit, & Intake ) is a modern, unified SaaS platform supporting full lifecycle claims administration with native Artificial Intelligence modeling powering robust Predictive Analytics, Smart Auditing, and flexible Intake functionality.




What type of business entities should use your products?


Our platform works best with TPA’s, Risk Pools, Public entities, Insurance Companies, Self-Insured, Self-Administrated firms, and other Professional Insurance Organizations.




Why is this a differentiator?


No other claims platform has this solution (or anything close to it) and no other claims administrator can seamlessly advantage AI and automation throughout all critical categories of claims administration.




Who would be a good candidate for this type of AI integration?


Virtually all claims administration organizations will likely be good candidates and will certainly experience the power of “native AI” enhancements to their workflow.




What is a KPI?


A KPI stands for Key Performance Indicator and Klear.ai provides any KPI’s that your organization might need in order to visualize data effectively with customization capabilities.




How do we create new KPI’s?


KPIs can be created by clicking the “+” sign on the top right corner. This will load a new window where you will be able to create any KPI your organization may need





13 reasons why KlearClaims will Future-Proof

your claims management software

1 - Fully integrated system where users can view the AI and ML predictions within the claim screens.

2 - Completely automated rules - auto-generation of correspondence, texting, carrier reporting, based on clients and jurisdiction all the way down to the organization level

3 - One system that can audit all claims continuously for compliancy and best practices

4 - Real-time pre-validated State and Federal Compliancy Submissions

5 -Role-based system to assign multiple privileges on a claim e.g., having a junior examiner and an overseeing trainer examiner on a single claim

6 - (AI) integrated Dynamic Dashboard for Claim status  

7- Priority and Event-based Task monitoring for efficient execution and workflow

8 - Incorporates Automated Business Rules into Case Management and Claim Activity

9 - Decreasing Adjusters’ efforts in handling Complex Multiple Client Handling Instructions

10 - Avoiding Late submissions to Carriers for non-acceptance of Claims

11 - Avoiding penalties regarding late/non-submission of statutory information ( CMS, FROI/SROI, etc.)

12 - Automation and Redirection to UR for Treatment Request. Providing suggestions for non-medical requests based on individual Client specifications

13 - Example – Providing Provider recommendations based on injury details and Claimant location