The first comprehensive, secure online system to manage all aspects of workers' compensation claims — from first report of injury through final settlement. Trusted by MCOs, TPAs, self-insured employers, and government agencies for over 27 years with 99.999% uptime.
Empowers risk managers, claims managers, adjusters, attorneys, TPAs, and MCOs with comprehensive solutions that link key risk, claims, and policy data — all phases from FROI through final settlement.
Complete IAIABC-format electronic reporting to all 50 states with automatic compliance tracking.
Three-tier bill adjudication with MCCI clinical edits, automatic repricing to lowest of billed, state fee, or PPO amount.
Complete payment processing with ACH, check printing, garnishments, and automatic reserves management.
URAC-accredited utilization review with complete medical case management, authorizations, and plan of care.
The ONLY software with Return to Work (RTW) and MODM standards built in — predicting costs and guiding Pay for Performance.
Integrated pharmacy management saves 15-40% off state fee schedules with national PPO network.
Integrated document management with My E-Docs™ — work flow, audit trail, routing, and stamps.
Complete legal review workflows with jurisdiction-specific forms and regulatory compliance built in.
The industry's most trusted workers' compensation platform.
18+ years of continuous web-based operations with industry-leading reliability.
Complete workers' compensation processing for all 50 states with state-specific compliance.
Enterprise-grade technology backed by IBM partnership and infrastructure.
Industry-recognized accreditation for utilization review and case management.
Join employers, TPAs, and MCOs nationwide who trust Claims Advantage™ for their workers' compensation claims management.
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