Changing lives isn’t simple.

But we believe simplicity can be life-changing.
Can simplicity go as far as changing someone’s life?
We think so. Sometimes in really big ways.

And sometimes in small ways that all add up to changing the big picture.

It’s why for more than 20 years, it has been our mission to simplify the complexities of workers’ compensation.

For every stakeholder whose life we touch.

Helping to speed and simplify the adoption of new technology

In this age of digital transformation further accelerated by the COVID-19 crisis, many workers’ comp organization have tech-focused priorities on their roadmap as they build with an eye on the future. It’s a significant lift in the best of times, and in today’s post-pandemic, tech-talent crunch, it might be out of reach for some to take on – at least on their own.

If like many claims organizations out there, you’re making decisions about what you can build and when you can turn to a partner, here’s where we can help:

Easier integration of vendors, resources and new technology within your claims environment
A single integration to connect to all parties
The reduction or removal of your IT project or resource burden

Using technology to create a more consistent, more powerful user experience

As we continue to try to attract claims talent to the industry, the bar becomes higher for what these new professionals expect in terms of the technology they use. Today’s digital consumer experience has us hardwired to be able to perform all our daily functions at our fingertips – from online banking, to controlling the security of our homes, and shopping at our favorite e-retailers.

Our powerful Verticē web application for claims professionals helps centralize their daily tasks, providing a single interface for all referral and authorization activity and helping to drive consistency across workflows, from prescription drug activity, to ancillary medical services such as physical therapy, diagnostics and more.

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Simplifying claims workflows and decision-making with automation and right-time decision support

Claims professionals are at the front line of claims management, and their challenges in this role are many. Working with disparate systems. Working with a multitude of vendors. Trying to coordinate all these services for the injured worker. It can become very complex, very quickly.

Our technology tools for claims professionals help support:

Faster identification and escalation of complex decisions that require greater focus and resources
Increased operational and workflow efficiencies
Reduction in manual, time-consuming tasks
Right-time decision support that helps simplify complex medical and financial decisions

Learn more about the experience offered by our technology for claims professionals.

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Leveraging advanced analytics strategies to identify barriers to recovery

A person’s behaviors, perceptions and characteristics are not left behind when they are injured on the job. With social determinants of health comprising up to 80% of modifiable factors impacting health outcomes, more and more workers’ comp medical program managers are embracing the need to identify these factors and their potential impact on a claim.

Here’s the good news: the data is all around us, just waiting to be uncovered. It just may not exist in the way that it is immediately useful. To this end, Healthesystems is leveraging AI-driven technologies such as natural language processing to help radically simplify the task of identifying behavioral and social determinants of health that impact a claim.

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Helping navigate therapeutic complexity with a concierge-style clinical program

In the ever-evolving prescription drug environment, therapeutic complexity – and the need to help navigate it – exists for every stakeholder. Our concierge-style clinical program is designed to do just this, providing our clients with access to the strategic expertise and guidance embedded within our clinical team, as well as workflow support and data-driven intervention strategies available at multiple touchpoints.

PROGRAM
Strategic formulary and rules development
ADJUSTER
Right-time formulary and decision support
PRESCRIBER
Monitoring, outreach and intervention
PATIENT
1-on-1 medication counseling

How can simplicity change lives?

Whether it’s helping to make a claims professional’s day easier, reducing today’s staffing and resource burdens for our customers, or helping a patient avoid exposure to inappropriate or even life-threatening therapeutic risks, we’re here to help simplify the complexities of the workers’ compensation journey for every stakeholder we touch.

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