We’re thrilled to introduce a new enhancement to our Pilot Scoring system! Now, customers can easily evaluate claims submitted prior to Pilot Scoring enablement, eliminating the need for extra development resources and resubmission. This feature grants the user greater visibility into past claims. Previously, claims submitted to ClaimSearch before Pilot Scoring activation needed to be manually resubmitted for scoring. With this new functionality, users can score these historical claims utilizing the same Rules and Reason Codes applied to current submissions, empowering customers to better assess the overall performance of our analytics.
Customers interested in utilizing the enhanced Claim Scoring solution suite can assess the value through Pilot Scoring. When enabled, Pilot Scoring functions as a sandbox environment where a carrier’s claims are duplicated and evaluated using our analytic Rules and Reason Codes. Additionally, customers can customize default settings, such as Rule weight and thresholds, by line of business through Claim Scoring Customizer, and create robust detection scenarios using Claim Scoring Architect. With this new functionality, users can now demonstrate the added value of Claim Scoring over time by rescoring older claims within ClaimSearch that may not have previously been flagged. Upon rescoring, the claims will be scored, and the expected analytic Rules and Reason codes will be generated. This provides the client with valuable insights and analytics that were previously unavailable, optimizing their claims workflow from both processing and payout perspectives, and facilitating the escalation of suspicious claims to their SIU. For information on how to utilize this feature, or any questions on functionality, please coordinate with your Client Success representative.
