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Workers’ Compensation Claims Solutions

Data-driven insights to improve workers’ comp claims

Complex claims and compliance costs insurers

Workers’ compensation insurers are challenged with managing complex claims, rising claim severity, and stringent reporting obligations. And with many experienced claims handlers nearing retirement, the challenges become even more daunting.

Powerful analytics help conquer claims challenges

Verisk’s data-driven claims solutions empower workers’ comp insurers to mitigate risk, contain costs, streamline claims processing, verify appropriate medical treatment, and enable accurate compliance reporting.

Automating insights to transform workers’ compensation claims

Sifting Through Data Thumbnail

Discover how workers’ compensation data can provide valuable insights through advanced automation technology for improved results.

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Wcnavigator

Identify severity faster with predictive analytics

Detecting claim severity early can help you improve triage, contain costs, and enhance employee return-to-work timelines. Our solution leverages predictive analytics to accurately identify workers’ comp claim severity as early as day one.

  • Scores and re-scores claims daily as new information is received
  • Integrates prescription and medical data directly from your PBM and MBR providers
  • Accurately predicts 88 percent of high severity claims within first 30 days
Learn about wcNavigator
Speed Precision

Speed and precision at claim intake and investigation

Streamline claims processing and improve SIU referrals with powerful tools that leverage robust industry data and analytics to deliver critical insights early in the life of a claim.

Learn about ClaimSearch

Discover the latest workers’ comp claims insights

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New Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5) takes aim at non-submit and EBMSAs

Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5, January 10, 2022).

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COVID-19 and Workers’ Compensation Revisited: Navigating the pandemic to understand what’s next

Last year we discussed ways the pandemic could impact workers’ compensation claims. Now, nearly a year later, we reflect on some of the answers to those questions.

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The COMP Act is reintroduced in the U.S. Senate

On 3/10/21, Senators Ben Cardin (D-MD) and Rob Portman (R-OH) introduced the Coordination of Medicare Payments and Workers’ Compensation Act (COMP Act) (S. 653) into…

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Starting March 27, 2021, CMS will use the 2018 CDC Life Table for WCMSAs

Starting 3/27/21, CMS has announced that it will use the new 2018 CDC Life Table to calculate adjusted life expectancies in Workers’ Compensation Medicare Set-Asides…

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Detect fraud in workers’ comp claims

Detect Fraud

Detect fraud in workers’ comp claims

Workers’ comp fraud is one of the fastest-growing types of insurance fraud. Fight it with our extensive suite of claims fraud solutions that leverages robust data and innovative technology.

  • Predictive analytics fueled by more than 1.5 billion claims
  • Medical provider fraud analytics that score more than 1.5 million providers
  • Advanced link analysis software that uncovers organized fraud activity

Streamline data reporting, improve compliance

Actionable insights, better outcomes

Untapped Workers Comp

Learn how workers’ comp analytics helped improve EDI compliance at Liberty Mutual and for the Commonwealth of Virginia.

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Achieve full Medicare compliance, reduce exposure

Medicare Compliance

Achieve full Medicare compliance, reduce exposure

Whether you need to quickly and accurately identify and report Medicare recipients, dispute conditional payment liens, or allocate future medical costs, our solutions and services help you comply with CMS and avoid costly penalties by providing you with key information to:

  • Satisfy Section 111 reporting requirements
  • Automatically fulfill MRN reporting obligations
  • Reduce conditional payments
  • Determine accurate workers’ comp Medicare Set-Asides

Verisk also provides additional claims reporting compliance solutions

Child Support Icon Child support intercept matching
Casualty Reporting Casualty reporting
Questionable Claims Questionable claims reporting
Ofac OFAC screening

Optimize claims resolution

Contact Us to Learn More

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