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AI (Artificial Intelligence) in Workers Compensation Claims Processing drives automated document sorting and abstraction

It used to be that parts of the processing of a Workers Compensation Claim were 100% manual. That is, a human got boxes of paper files or electronic pdfs (or other formats) related to a disability claim and was tasked with deciding which ones went into which stacks or folders. This sorting operation could take hours – or days – and had to be completed before the doctor even started to review the claim.

In today’s world, scanned documents and pdf files are automatically sorted by category, using Artificial Intelligence (AI). AI/Machine Learning software works with Optical Character Recognition (OCR), Natural Language Processing (NLP), and other smart technologies to decide WHO the document came from, WHAT it says, WHERE it is going next, WHY it is going, and HOW the document will be used now and in the future.

For the same job, manual sorting speed is 2k~3k pages per hour, versus seconds for AI. And, unlike the manual sorting, AI is also comparing what it understands to everything in the database. Pretty cool!

AI doesn’t make the hard decisions around recommended outcomes. Those require a human (for now). What AI does do is answer the questions that inform those decisions.

Want to know if the person being treated has been treated previously? AI

Want to know if this is a duplicate document? AI

Want to get an idea of all of the previous medical conditions experienced by this person? Yep. AI!

AI delivers faster results accurately and less expensively, and handles many tasks in parallel. Beyond intelligent sorting, AI is being deployed in the Workers Comp area to transform a wide variety of disparate data into actionable information, giving organizations of all sizes a competitive edge.

6 more ways your organization can leverage AI to control Workers Compensation costs

 

1 – Find and hire skilled, dependable people with a proven track record for safety.

2 – Correlate employee experience levels, missed days following an accident, errors, wasted time, and company ergonomic policies.

3 – Review data via customized dashboards to investigate and analyze the effects of an accident on the workforce and on the organization’s bottom line.

4 – Track the costs of return-to-work, rehab, lost wages, and disability settlements.

5 – Analyze red flags configured to indicate when an injury report needs further investigation.

6 – Track time-sensitive claims reporting to avoid severe late penalties and fines.

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