Clearspeed’s one-to-one, in-the-moment assessments unlock a new way for
workers’ compensation insurers to quickly understand who or what to trust.
The road to recovery from a workplace injury and the management of a worker’s return to work can be a long journey, but that shouldn’t apply to risk management. Real-time insights into potential fraud is becoming essential in managing active workers’ compensation claims. Factors that drive claimant escalations and costs often emerge gradually and can be missed in periodic file reviews alone. Unfortunately, these claimant checkpoints offer limited, unverified information, and rely too heavily on self-reporting. These small inconsistencies often turn into costly, long-tail claims. Without good data insurers struggle with confidently understanding who or what to trust.
Better manage potential fraud throughout return-to-work cycles
Clearspeed is purpose built to solve for the tension between speed and accuracy at regular workers’ compensation claim management touchpoints. Our individualized and real-time assessments of risk unlock a new way to understand potential risk of fraud in real time, providing a new insight that enables better, faster decision-making, and remedies the tradeoff between pace and rigor.
Fast, individualized assessments
Clearspeed analyzes the responses to a short set of customized and automated yes/no questions for universal vocal characteristics known to be associated with risk. This delivers a point-in-time, individualized assessment of potential fraud for each claim on a number of key areas where data is previously hard to verify or validate:
- Inconsistent work restrictions or impairment ratings
- Activities contrary to claimant’s injury severity statements
- Excessive symptom reporting
- Delayed or inappropriate care
- Provider patterns of overtreatment or excessive diagnostics
- Unusual billing
- Poor recovery trajectory without clinical explanation
- Avoidance of communication
- Non-compliance with treatment or return-to-work programs
- Personal gains (financial, lifestyle, secondary employment)
- Up-coding and double billing
- Repetitive doctors appearances in other claims
- Claims trending above expected medical/indemnity benchmarks
- Co-worker collusion
Easy insertion into existing workflows
The Clearspeed voice-based risk assessment process starts with claimants being presented with the Clearspeed questionnaire on any voice-enabled device. Clearspeed analyzes the claimant’s vocal response to the case-specific question set, quickly identifying and scoring indicators associated with risk. Individualized results are then returned via API or available with the Clearspeed web app to inform next steps in claims pathing.
Clearspeed Benefits
