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Navigating Casualty Claims in a Perplexing Medical System

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When an injured worker or driver seeks medical treatment after an accident, the medical provider has 14,400 choices on how to describe the injury for reimbursement. New global standards will boost that list of options to 55,000. This overwhelming complexity of medical codes exposes property & casualty insurers to intentional fraud, innocent errors, and internal mismanagement. With 90% of claims operations to be automated by 2030, how will insurers maintain payment integrity providers in such a befuddling medical system?  

This webinar will discuss:

  • The reality of elusive diagnoses - a typical worker's compensation medical bill is paid on behalf of a claimant with three diagnoses in the first week and eight diagnoses in the first year
  • Why understanding the trajectory of medical billing codes critical to anomaly detection and large loss prediction
  • How Teradata Vantage enables insurers to:
    • Engineer synthetic variables to enrich claims triage models
    • Deliver highly interactive and transparent business-facing applications
    • Customize solutions using their preferred tools of choice