CareMC Edge: Claim File Review Platform Qorus Innovation in Insurance Awards 2021

Claims review has been done the same way for decades—four times per year, the claims team spends countless hours printing endless stacks of papers to create the enormous binders that will be poured over for hours. It is an antiquated process that is a pain point for claims professionals and customers. What if we could eliminate this time-consuming, inefficient process? That’s the question that CorVel kept asking. By leveraging technology, CorVel’s digital platform has the ability to provide easy access to claim information and documentation, which means with one click of a button you can view the details of a claim, make changes, or monitor for potential issues. Electronic claims review provides a real-time snapshot of a claim at any time and offers visibility and transparency to all stakeholders, ensuring that everyone is on the same page at all times. This new feature, which is part of CorVel’s CareMC Edge platform, streamlines collaboration among stakeholders so agreed upon interventions can be completed and documented, immediately. The electronic claim review platform does three key things: 1. It creates transparency and provides complete visibility to everyone involved with the file review. 2. It allows claims managers to track claims that may need attention by enabling alerts that can be customized to meet the needs of the customer and ensures that interventions are executed and documented within the claim file in real-time. 3. It reduces the time that the claims team has to spend sorting through documents, searching through notes, and following up to confirm that action was taken, and allows them to spend more time focused on the injured worker and making changes that will impact the claim.