Early telephonic intervention for predicted risk
Referral Expert® is an automated process to identify claims that would benefit most from telephonic case management. Referral Expert scores new and existing claims for appropriateness of clinical management and responds to claim events as soon as they’re reported for immediate triage and earliest intervention. Our nurse case managers leverage the predicted risk profile produced by Referral Expert combined with their experience to select only appropriate cases for early intervention. We work with our customers to design the approach that makes sense for their program.