Strataware® Auto Medical Bill Review

The leading bill review platform for automated and rules-based bill review is now available as a first party auto casualty solution.

Medical bill review for auto insurance claim services

While the pandemic emptied roads, drivers are hitting the roads again. Reports indicate that the number of miles driven are increasing and so are the number of medically consulted injuries.To avoid overpayment and penalties, it’s imperative that insurers verify that every charge is compensable, appropriate to the motor vehicle incident, and compliant with the latest state laws and statutes. Additionally, the final payment recommendation must not only accurately reflect deductibles, copays and policy limits, but also all network discounts and negotiated agreements.

Strataware, Conduent’s flagship product for casualty claims medical bill review, delivers automated reviews and repricing for auto first party and Medical Payments (MedPay) and Personal Injury Protection (PIP) claims.

Platform Overview

Conduent’s automobile first party functionality gives casualty claims organizations the ability to process both auto and workers’ compensation medical bills through a single platform.

Auto bill review closely mirrors workers comp, but there are important differences. Conduent has designed Strataware Auto for this unique line of business.

  • Claim file allows for multiple claimants and policy coverages
  • Deductibles, copays and policy limits are automatically applied during bill processing
  • Reductions for deductibles, copays and policy limits are clearly displayed in the explanation of review (EOR)
  • Compliance with state jurisdictional requirements
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Strataware® Auto Features

  • Automated Policy Coverage Tracking

    Real-time tracking of policy limit paid to date, deductible applied, and copay balance

  • Configurable and Dynamic EOR

    Explanation of review is configurable and only displays policy reductions when a reduction has been applied
    New York State Form NF-10 compliant

  • Shield Claims Portal

    Single sign-on access to real-time dashboards and actionable tools for bill management, claims monitoring and workload balancing

  • Pathways Dynamic Rules Engine

    Easily apply your specific rules for bill routing, review, and repricing to improve adjudication and exception handling

  • SmartAudit Tool

    Powerful bill auditing tool for internal quality control and reporting

New Jersey Solutions

Conduent provides a complete solution to help you manage compliance with the Automobile Insurance Cost Reduction Act (AICRA) for New Jersey first-party casualty claims.

  • Decision Point Reviews
  • Pre-certifications
  • Data ingestion into Strataware®