Claims Management

CareMC Edge: Smarter claims technology.

Claims management has never been easier with CareMC Edge, which leverages best-in-class technology to deliver greater transparency, help employees recover more quickly, and maximize savings. With over 30 years of experience, we’ve enhanced claims management so professionals outrun risk and get ahead of costs.

Why CareMC Edge?

One integrated platform for all claims management solutions.

CareMC Edge connects all stakeholders throughout the entire claims process, providing real-time updates and streamlining communication to optimize an employee’s recovery and employer’s savings. It’s a comprehensive way of managing claims–providing all the tools needed to make informed decisions with confidence.
Claims Risk Score

Get a personalized risk assessment.

  • We use advanced technology to rate all data elements on a claim and grade its level of risk.
  • Several factors such as return-to-work estimates, physical demand requirements, pain levels, and more are incorporated to conduct an accurate evaluation.
Comprehensive Claims Management

Manage everything, all from one place.

  • Dynamic and interactive high-level overview of your entire program, delivering essential claims data and next steps through the entire process.
  • Actionable insights for adjusters, period-over-period benchmarking, litigation information, and more.
  • Complete visibility and real-time information through every stage to keep return-to-work progress on track.
Patient Care Management

Ensure employees access quality care.

  • Insights into pharmacy management of drugs and treatments.
  • Access to specialty medical services to ensure holistic recovery.
Provider Portal

Simplify payments and communication.

  • Network providers can easily access payment information, submit medical bills, and send return-to-work documents directly to us.
  • Complete visibility into payment status and provider details. 
  • Return-to-work updates and communications streamlined.
Case Management Technology

Smarter tools for case managers.

  • Ongoing access to resources for case managers to proactively guide patients and deliver high-quality care.
  • Predictive modeling for identifying potential barriers to recovery.
  • A direct line to providers for immediate scheduling with specialty networks.

Learn more about how CareMC Edge can help you manage claims and reduce costs.

Ready to get started?

Our team is ready to answer any questions and help you find the right solutions.