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Description
ClaimScore stands out as the sole independent software solution focused on tackling the growing issue of claim fraud within class action settlements. Each claim is meticulously assessed on an individual basis through our unique AI, ML, and Cloud Architecture in real-time, with results displayed instantly on an interactive dashboard. Initially, every claim starts with a ClaimScore of 1,000, which diminishes whenever it does not meet a specific criterion. These criteria are assigned either fixed or variable weights based on their relationship to fraudulent and legitimate claims. To enhance transparency, every claim is accompanied by deduction codes that correspond to the failed criteria, ensuring that all involved parties, including the administrator and the court, are fully informed of the precise reasons behind any claim rejection. This meticulous approach not only fosters trust among stakeholders but also reinforces the integrity of the claims process.
Description
Claims Signal™ represents a revolutionary open claims quality solution developed by Aon and Athenium Analytics, designed to help insurers detect high-risk claims at an earlier stage. By improving the experience for policyholders, this platform can lead to a significant enhancement in claims indemnity and expenses, estimated between 4% to 6%. In today's fast-paced insurance environment, claims teams face mounting pressure to elevate customer satisfaction, streamline operations, and minimize financial leakage. While routine quality audits can effectively highlight root causes and deviations from optimal practices, the feedback from these audits may not be accessible for weeks or even months post-claim closure. Imagine having the ability to continuously monitor open claims and resolve quality concerns before they negatively impact results. The Claims Signal platform leverages advanced artificial intelligence to scrutinize open claims, identify potential problems, and send immediate alerts, empowering front-line managers to take action before a claim reaches conclusion. With the integration of predictive analytics and timely alerts, insurers can achieve a reduction in claims leakage of up to 4%, ultimately transforming the claims management process. This proactive approach not only enhances operational efficiency but also fosters a culture of continuous improvement within claims teams.
API Access
Has API
API Access
Has API
Integrations
No details available.
Integrations
No details available.
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
No price information available.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
ClaimScore
Founded
2022
Country
United States
Website
www.claimscore.ai
Vendor Details
Company Name
Athenium Analytics
Country
United States
Website
www.athenium.com/products/claims-signal/
Product Features
Insurance Claims Management
CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting
Product Features
Insurance Claims Management
CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting