Generative AI for CareMC Qorus Innovation in Insurance Awards 2024

As AI transitions from an emerging innovation to a tried-and-true resource, CorVel is leveraging generative AI to accelerate claims processing and streamline adjuster workflows, offering a revolutionary approach to a field characterized by high volume, manual tasks.

Phase One of CorVel’s generative AI services is a dedicated effort aimed at revolutionizing the efficiency of medical document review processes, with the objective of optimizing speed and accuracy. Leveraging natural language processing, the generative AI solution is trained to read and summarize complex medical information, provide summaries to adjusters, and propose actions to be taken. Simultaneously, the extraction of unstructured data from the reports will be highlighted so that claims staff can update claim fields quickly and efficiently in CareMC and ensure that key stakeholders are notified.

This solution significantly reduces the adjuster’s time commitment to objective tasks, enabling more direct interaction with injured workers, participation in strategic endeavors, and ultimately enhancing managed care health and care outcomes while optimizing resource allocation and boosting adjuster productivity. CorVel aims to set new standards for speed, accuracy, and productivity in the industry, benefiting both adjusters and the people they serve.

In subsequent iterations, CorVel’s generative AI solution will learn from past claims and generate new information that matches established patterns, thereby reducing the workload of claims administrators and enabling faster claim closures. This capability will also garner use cases in fraud detection, using predictive capabilities to identify anomalies or inconsistent data. In addition, the generative AI solution will also enhance customer service and engagement by leveraging AI-powered chatbots to answer queries and provide support throughout the claims process.

The long-term impact of CorVel’s generative AI solution will include the increased satisfaction of valued employees who are empowered to participate in person-centered work, thereby boosting overall retention within the insurance industry as a whole.

Key Benefits of CorVel’s AI Offering: 1. Redefining Efficiency 2. Elevating Processing Speed 3. Streamlined Workflows 4. Actionable Insights 5. Scalability and Adaptability 6. Empowering Adjusters