Empowering Your Adjusters and Improving Your Bottom Line

The Acrometis flagship claims processing solution offers unparalleled workflow management, with documents automatically routed by a configurable rules engine. Based around claim assessment scoring, body part to claim compensability matching, jurisdictional directives, relatedness scoring and a host of other claim elements the Acrometis business rules are designed to reduce claim duration and costs.


65% Auto-Adjudication

Automatically processes incoming documents with NO adjuster intervention


Serious Bottom Line Results

Clients typically see between 11 and 23 points medical loss improvement in the first year


More Than Bills

CLAIMExpert contains rules for over 190 different document types, quickly handling whitemail and any other documents that come across your adjuster’s desk


Free Reserves Faster

Adjusters using CLAIMExpert closed medical claims over 50% faster, freeing up reserves

CLAIMExpert automatically processes 65 percent of incoming medical bills and non-medical documents with no user intervention. Documents requiring adjuster intervention are flagged and sorted for easy review and straightforward decision making.

How Can CLAIMExpert Help You Reduce Costs?

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Related Services

Acrometis offers several services to be incorporated into CLAIMExpert, but if desired will enhance your claims operations separately as standalone upgrades

ODG Scoring

Acrometis has partnered with MCG to embed their Official Disability Guidelines (ODG) directly into our systems. These evidence-based guidelines are the product of decades of research and over 10 million cases. They have been adopted by 100,000 users and are widely considered to be industry-best standards when it comes to treatment and return-to-work.

With this integration, adjusters will have every aspect of their claim available to them in one spot, presented in an easy-to-use interface that allows them to monitor their claims easily and accurately. Our system continually cross-references claims against the ODG knowledge base and can determine if claims are performing as they should. If they are not, adjusters are quickly alerted and can take action.

  • The power of Acrometis’ business rules and workflow automation tools coupled with ODG’s comprehensive guidelines

  • States adopting ODG have seen huge reductions in medical costs, lost time/disability, treatment delays and premiums

  • Claims are continuously monitored against guidelines, if anything is out-of-the-ordinary adjusters will know

Check out our ODG Overview and download an easy one-page summary of the tool

Taking an evidence-based approach to ensure successful claims management

  • Evidence-based treatment and return-to-work guidelines are applied to claims

  • Automatically flags services that exceed best-practice recommendations or user defined allowances

  • Identifies claims that may be candidates for nurse case management, etc. triggering a referral if necessary

  • Identifies potentially problematic claims early on, saving money and time

  • Assists with reserve oversight, takes the guesswork out of reserve setting

  • Automatic and pre-populated referrals save adjusters time and reduces errors

  • Embedded directly into our systems, changes in ODG scoring or best practices are automatically reflected in the user interface

  • Claims are continuously monitored against guidelines

From MCG: Every claim is assigned a Risk Assessment Score (RAS) which changes as claim characteristics and comorbidities are added. The higher the score, the more closely adjusters should pay attention.

Learn more about ODG

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Referral Tool

Pre-populates and Automatically Sends Referral Requests to Negotiated Partners

  • Uses indexed data to pre-populate forms

  • Automatically sends reliable referral requests to pre-negotiated partners

  • Users can check on a referral status at any time

  • Pre-populated forms save time and avoid potential errors

  • Maximizes network penetration

  • Status check-in ensures claims are staying on track

  • Embedded directly into our systems, user selection of a specific partner network presents the appropriate and agreed upon services offered by that partner

Learn more about our Referral Tool

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Relatedness/Rarity Screening and UR Enforcement

Relatedness/Rarity Screening and UR Enforcement

  • Our systems scan bills for relatedness to claims at-hand

  • Also cross-checks for rarity in workers’ comp

  • Mechanism to ensure UR reviews are compliant

  • Avoid allowing things to slip through the cracks

  • Pay for claim related services and ensure they are medically necessary

  • We can use the claim feed you already share with a vendor or partner

  • We support medical bills and document images in their existing forms

  • Acrometis integrates with bill review partners

Learn more about Relatedness/Rarity Screening and UR Enforcement

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