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MEMIC Taps CLARA Analytics for AI-Powered Claims Management

by Fred Pennic 01/18/2024 Leave a Comment

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What You Should Know:

– Maine Employers’ Mutual Insurance Company (MEMIC), a leader in workers’ compensation insurance, is harnessing the power of artificial intelligence (AI) to revolutionize claims management.

– MEMIC announced its partnership with CLARA Analytics, a provider of AI solutions for the insurance industry, to implement CLARA Optics, a cutting-edge platform that promises to streamline workflows, improve medical outcomes, and empower adjusters and nurse case managers (NCMs).

Harnessing the Power of AI

CLARA Optics leverages a potent combination of predictive AI, generative AI (GenAI), and large language models (LLMs) to tackle the mountains of paperwork associated with workers’ compensation claims. This translates to:

  • Automated medical records processing: Say goodbye to manual transcription. CLARA Optics extracts key details from medical records, saving adjusters and NCMs valuable time and effort.
  • Real-time case insights: Up-to-the-minute case summaries keep claims managers informed about the latest developments, ensuring they can make informed decisions quickly.
  • Actionable recommendations: CLARA Optics doesn’t just provide information; it offers actionable suggestions to guide adjusters towards optimal outcomes, including faster case resolution and reduced costs.

Beyond Efficiency, Better Outcomes

The benefits of CLARA Optics extend beyond streamlining workflows. The platform’s predictive capabilities identify potential “jumper claims” at risk of escalation, allowing proactive intervention to get injured workers back on the job faster and reduce overall costs.

“We anticipate that CLARA Optics will create greater efficiencies across our claim operation,” said Matt Harmon, senior vice president of claims at MEMIC. “This innovative technology will empower our team to focus on what matters most: supporting injured workers and policyholders.”

CLARA Optics: A Secure and Accurate Solution

Unlike many AI tools, CLARA Optics prioritizes data privacy and accuracy. Insurance carriers’ data remains confidential and secure, both during model training and operational use. Additionally, CLARA Optics delivers unmatched accuracy by basing its insights on verified internal data sources and employing redundancy checks.

Priced on a per-page basis, CLARA Optics offers flexibility and affordability, allowing MEMIC to optimize their claims process without breaking the bank. With its powerful AI capabilities, MEMIC is poised to set a new standard for efficiency, accuracy, and ultimately, better outcomes in the workers’ compensation landscape.

“MEMIC has always been a pioneer in the workers’ compensation space. We’re thrilled to see them continue this tradition by embracing CLARA Optics. This partnership will not only improve their claims management but also empower their adjusters and ultimately benefit injured workers,” said Heather H. Wilson, CEO of CLARA Analytics.

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