Technology Enhancements to Conduent’s Strataware Platform Help Workers Compensation Payers Reduce Medical Spend

Conduent Incorporated, a business process services and solutions company, announced two new enhancements to its highly configurable Strataware medical bill review platform. Strataware Relatedness and Strataware Rarity add greater efficiency to the bill review process and help workers compensation payers reduce medical spend with proprietary algorithms, advanced logic and automation to ensure that only compensable medical expenses are paid.

Strataware Relatedness identifies medical bills which contain ICD (International Classification of Diseases) diagnosis codes for treatment not related to an injury. Strataware Rarity highlights medical services that are unlikely or rare for a workers compensation claim. Conduent analysis of more than one million medical bills using Relatedness identified nearly 33 percent contained charges for treatment not related to a workplace injury, accident, or illness. An analysis of 2.3 million medical bills using Rarity identified 10 percent of bills contained diagnosis codes for conditions that are rarely treated in workers compensation.

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“The need for enhanced automation to drive payment accuracy has never been more important to workers compensation payers. We are helping our clients address an increasingly complex medical review process due to the impact of COVID-19, combined with the rise in comorbidities and preexisting conditions, an aging workforce, and changing regulations,” said Beth Fritts, General Manager for Casualty Claims Solutions at Conduent. “Against this backdrop, billing codes for unrelated health conditions can be easily overlooked during the bill review process. Relatedness and Rarity are highly automated solutions that use analytics and business intelligence to reduce overpayments and improve the effectiveness of adjusters.”

Conduent’s Strataware platform processes over 26 million medical bills annually for U.S. workers compensation insurers and third party administrators. Conduent Casualty Claims Solutions provides industry-leading technology, clinical services and actionable analytics to the workers compensation and auto casualty markets. Solutions span bill review, injury reporting, claims intake, 24/7 nurse triage, virtual nurse case management, and automated document solutions.

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