Workers’ Compensation Claims Management

Our roots are in Workers’ Compensation. ClaimPilot was originally built more than 20 years ago as a comprehensive Workers’ Compensation solution for third-party administrators and self-insured entities. With a time-proven track record and a 99% retention rate, our cloud-based claims management software is highly acclaimed for its seamless management of Workers’ Compensation claims in all 50 states. 

The broad range of modules built into ClaimPilot takes the guesswork out of managing claims for work-related injuries, occupational diseases, and workplace-incurred fatalities, and complying with a wide range of policies, regulations, and reporting requirements. Among the key features:

  • Variable input fields make it simple to enter parameters, such as state-mandated waiting periods.
  • The work status module tracks the important details associated with a worker’s lost time and restricted duty.
  • Our integrated electronic data interchange (State EDI) module makes it easy to comply with complicated state requirements for electronically reporting Workers’ Compensation data ­– first report of injury, initial payment, change in benefits, final claim and suspension of benefits, among others – under each state’s respective jurisdictions.
  • The OSHA module allows you to flag and electronically report OSHA-reportable claims and also generate OSHA logs for TPA clients.

ClaimPilot’s best-in-class platform generates and reports Workers’ Compensation payments accurately and timely to ensure compliance and shield you from financial implications. 

  • ClaimPilot handles complex payment calculations.
  • Our payment module makes it simple to automatically split payments to multiple recipients beyond the injured worker for child support garnishments and legal fees.
  • Both single and split payments, as well as detailed compensation reports, can be scheduled to generate automatically.
  • The recurring payment function enhances the simplicity of managing Workers’ Compensation claims.
  • A review screen provides a weekly snapshot of scheduled payments and final scheduled payments prior to the check run or electronic remittance.
  • State forms for all 50 states can be generated in ClaimPilot and easily attached to claims.
  • Compensation reports can be customized to break down claims by indemnity type, case, claim, injury date, claimant and amount paid.
  • ClaimPilot also has the capability to manage and report claims covered under federal statute, including the Jones Act for domestic maritime commerce employees and the Longshore and Harbor Workers’ Compensation Act for maritime workers not covered under the Jones Act. 
  • Our integrations for companies associated with
    cost containment and pharmacy card benefits allows those service providers to easily
    upload bills to ClaimPilot. 

When you schedule a demo to see ClaimPilot’s seamless
functionality and time-saving features, you’ll be taking the important step
toward managing Workers’ Compensation claims and complying with state and OSHA reporting requirements.