What's new with AI (Artificial Intelligence) in Workers Compensation Claims Processing?

• Author: Ross, Kevin
• Position: [GUEST OPINION]

It used to be that certain parts of the processing of a Workers Compensation Claim were 100% manual. The gathering, organization, and analysis of files - the first step in processing any new claim - was an unavoidably time-intensive task. A human got boxes of paper files or electronic pdfs (or other formats) related to a disability claim and had to decide which ones were pertinent or non-pertinent, which ones were redundant, and which ones went into which stacks or folders. This sorting operation could take hours - or days - and had to be completed before the doctor even started to review the claim.

AI has changed th at. Increasingly, scanned documents and pdf files are now being automatically so rt ed by category, using Artificial Intelligence (AI). AI software works with Optical Character Recognition (OCR), Natural Language Processing (NLP), and other smart technologies to decide WHO the document came from, WHAT it says, WHERE it is going next, WHY it is going, and HOW the document will be used now and in the future.

For the same job, manual sorting speed is 2k-3k pages per hour, versus seconds for AI. And, unlike manual sorting, AI uses Machine Learning (ML)/Deep Learning (DL) to simultaneously compare what it understands to everything in the database. Based on continually evolving algorithms, the original data is ingested, curated for relevance, and orga ni zed. The end-user, such as an IME, carrier, or attorney receives an indexed, searchable hyperlinked master document and summarization for case review...