Reliance Matrix uses artificial intelligence to review and prioritize every disability claim, every day, enabling us to put the right specialist, on the right claim, at the right time.
Our software acts as an AI-partner with our claims team to reprioritize thousands of claims on a daily basis to focus our time and energy on the claims that are ready for immediate action.
AI is the ability for computers to think like us, so they can help us make better decisions. It can mimic human reasoning by using a neural network – which is a series of algorithms modeled after the human brain – to identify trends and make decisions on its own.
To us, the use of AI is not about automation. Rather, it builds a deep partnership between the intelligent machine and the claim specialists, using its decision recommendation engine to identify claims requiring our expertise or action.
We've created a "brain" that understands complex, overlapping medical codes from thousands of ICD codes to identify historical patterns and predict new ones. This gives our claims team early guidance so that the claim durations are shorter and actionable.
Our software combines real-time predictive accuracy and explainable AI that clearly presents the rationale for action. It does this by distilling massive data sets to understand medical injury recovery like a doctor, make and explain action recommendations, and then repeat the process daily to prioritize the highest impact claims ready for immediate action.
While there are often only 2 or 3 codes relevant to a claim in its structured format, there are usually 12 or more codes in unstructured notes that can impact whether or not the claim is successful.
Artificial Intelligence can find these unstructured data points and create a radar-like map of how those factors all impact a particular claim. Add in historical knowledge of tens of thousands of resolved claims, the software can predict claim trajectories and optimal outcomes and actions.
|✓||Support resolution-ready employees as they transition back to work.|
|✓||Apply their expertise to the most complex claims.|
|✓||Assist employees in the best course of action for medical recovery.|