Santa Clara, CA – CLARA analytics recently announced an advanced AI-based toolkit to assist risk managers in evaluating an entire claim population’s performance, understanding the underlying costs that affect a group of claims and predicting trends that could have a negative impact in the future. The new Risk Management Toolkit is part of the CLARA claims product, which utilizes AI to help adjusters better manage claims in real time and identify at-risk claims before they escalate.
The Risk Management Toolkit is unique in that it leverages a variety of machine learning and natural language processing techniques to analyze both structured and unstructured data, such as observations mined from claim notes, medical records, images and other documents. Incorporating unstructured data into AI models results in more accurate and detailed analysis that can inform decision-making and reduce the severity and frequency of claims.
Risk managers can use the toolkit to conduct on-demand analysis that identifies the factors driving claim complexity and attorney involvement. They can also review the providers and attorneys that affect costs within a group of claims to ascertain their macro impact versus what happens in a single claim. Analysis is based on the predicted complexity of claims and is case-mix adjusted to offer a more precise and in-depth look than the average severity and frequency levels commonly found today.
“Risk management has always been constrained — by time and by the types of data that could be analyzed,” said Rohit Nair, product manager at CLARA analytics. “We’re changing this today, supplementing traditional trend analysis with AI and machine learning to pull out the gold nuggets from claim portfolios that signal adverse trends. This new holistic view empowers risk managers to efficiently address underlying costs.”
Because the new tool tracks trends over time, it is able to rapidly identify potential high-severity claims. Machine learning-based alerts are triggered when adverse trends occur so that claims teams can make necessary adjustments. Users do not have to wait for alerts to get an accurate read on what’s happening with a group of claims or to see the big picture. They can easily create custom dashboard views with extensive filters to generate reports to guide decisions based on up-to-the-minute data.
Source: CLARA