Insurers don’t typically get a full understanding of a 1st or 3rd party injury until further along in the claim lifecycle. When insurers don’t have the information they need to set appropriate reserves and understand suitable treatment, it can lead to delays in claim approvals and inefficiencies in the claim lifecycle.
At Talem, we’re focused on getting insurers the injury insights they need at the start of a claim to make better decisions upfront.
Talem’s AI-enabled injury analysis platform provides insurers with possible occupant injuries to gauge severity and determine an accurate diagnosis, an effective treatment plan, and recovery model.
At first notice of loss, with basic claimant information and car crash photos, Talem analyzes the forensic data to determine delta-V; or the severity of the accident. Using 9/10 ICD coding, Talem compares the reported injuries to their proprietary forensic rules engine to determine how likely the injuries reported are based on occupant motion and force exposure.
Understand the severity of the incident with speed estimates (Delta-V), occupant movement, and likelihood of contact with objects.
Gain a clear outlook with a realistic timeline for recovery of injuries based on the likely injuries, the persons age, and the physicality of their job.
Get a detailed overview of the likely and unlikely injuries caused by the accident based on a massive amount of historical crash data and our forensic rules engine.
Using key features of the crash and characteristics of recovery, Talem supports you with the most important injury-related data to make decisions immediately.
Healthcare providers are often incentivised to determine injuries are a higher severity to enable more frequent or costly billing on the claim.
Within the initial phase of the claim you must ensure appropriate billing and medical necessity. Talem pairs the Biomechanical review of injury causation with a medical expert to review the medical file to date.
Understand the incident, the likelihood of injuries involved and recovery trajectory.
Get a detailed breakdown the providers assessment; understand the valuable and missing information, treatment summary, quality and overall causation evaluation.
Understand the appropriateness of current billing. Talem reviews medical billing and compares with injury causation, gold standard geographical frequency and cost comparisons to ensure you reduce excessive and fraudulent billing.
Balance advanced technical forensics with the experience of a professional. Talem's platform leverages a network of medical professionals to build on early insights and analyze complex claim situations.
Not all claim cycles are straightforward. That’s why we’ve partnered with a custom network of medical professionals to offer our customers a direct link to the experts.
Blend expertise with technology by requesting an Independent Medical Examination or File Review enhanced by our biomechanical review. Medical professionals are given the data they need to make better informed conclusions on injury causation, clinical plateau, and medical necessity.
This data-enhanced service ensures better customer outcomes through accurate diagnosis and an accelerated claim lifecycle.
Talem Health Analytics understands the complexities that surround bodily injury claims, ultimately claims exist requiring intervention of human medical expertise. Our network of file review and Independent medical exam doctors evaluate the Biomechanical review, medical file and the claimant to develop a comprehensive review of the injuries and medical necessity.
Understand the incident, the likelihood of injuries involved and recovery trajectory.
Medical specialist evaluates the file to date, to provide expert opinion on medical necessity, clinical presentation, clinical plateau, treatment cessation or recommendation.
Timely and appropriate claims information enable insurers to proactively manage and provide a clear path to improved claim outcomes. Talems’ end to end injury causation services provides the right injury and medical necessity information at the right time. Contact us now to start your first notice of loss with a Biomechanical review or consult with an industry expert to determine which services best suit your needs.
