Medical necessity predictor

Identify non-motivated treatments

Mavera DSS automatically flags treatments that are not medically motivated, enabling health insurers to approve or reject treatments with confidence.

mavera augmented case view

Cost savings

Our customers save millions of euros yearly by avoiding medically unnecessary treatments.

Enhancing patient safety

Surgeries come with risks. By identifying unnecessary treatments, you can decline them or offer alternatives to your customers.

Boost efficiency

The system guides your focus on priority claims and provides detailed insights for each.

Navigating Treatment Approvals:
Cost vs. Cure

The cost of medical treatments is central to the health insurance business. However but the most effective treatments aren’t necessarily the most expensive.

Some clinics suggest surgeries, while others recommend physical therapy. Bear in mind that they are also businesses.

The insurer’s challenge is to decide what treatments to approve or not. The volume of treatment requests makes it impossible to investigate every request, but where to start?

Mavera DSS Timeline

Automatic treatment review

Mavera DSS reviews all treatment requests and suggests an action path: approve, decline, further investigation, or escalate to a medical advisor. This method enables insurers to spot treatments that aren't medically motivated efficiently.

Mavera DSS library

Case management

Get control over each treatment request and associated costs, with all information securely consolidated in one system and the augmented case view feature, you'll gain comprehensive insights into the customer's medical situation.

Optimize collaboration with healthcare providers

Mavera DSS offers a clear overview of your healthcare providers and allows you to define specific guidelines on how the system reviews treatments from that provider.

Get automatic second opinions from medical advisors

The system can automatically send complex claims to a suitable medical advisor for an in-depth assessment.

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How Mavera DSS strengthens the claims handlers' capabilities

Let's look at how Mavera Decision Support System (DSS) can enhance the accuracy and efficiency of personal injury claims handlers.

How AI will make "simple" claims even simpler

Many insurers across Europe use the skills and experience of their claims handlers to settle simpler claims themselves, without the involvement of medical experts. This is what we call “desktop assessments”. And in many markets, this kind of evaluations are on the rise. Why?

Maximizing efficiency in claims with intelligent document processing

Evaluating personal injury claims can be complex and time-consuming, particularly when they come with hundreds of pages of medical records the claims handler must read to understand the details of a case. This is where IDP technology comes in.