Every claim decision, in one governed system.
Claimatix connects utilization review, pharmacy benefit review, bill review, peer review and case management for workers' compensation. Evidence goes in, a traceable decision comes out, and a clinician stays in charge of every judgment call.
Built for complex workers' compensation operations
Clinical expertise
Physician judgment where it matters
Human-in-the-loop AI
Automation within set boundaries
Decision-level audit trail
Every input, reviewer and outcome
From request to resolution, without the handoffs.
Most claims operations are split across vendors, inboxes, portals and phone calls. Claimatix runs one governed workflow, without forcing every participant into another system.
Step 1, treatment
Clinical decisions that move faster
Intelligent intake, utilization review, pharmacy benefit review and physician peer review, coordinated from one queue.
- Utilization review
- Pharmacy benefit review
- Peer review
Step 2, payment
Context behind every dollar
Clinical history and policy logic connect to bill review, so payment decisions are consistent, explainable and ready to act on.
- Medical bill review
- Payment decision support
- Exception routing
Step 3, outcomes
A clear path to recovery
Case managers and care teams share one view of treatment progress, barriers and next actions, with human judgment intact.
- Case management
- Treatment coordination
- Outcome tracking
Different stakeholders, one source of momentum.
Each party sees the part of the claim they own, and the whole record stays in one place.
Replace fragmented services with one governed decision layer.
Deploy focused workflows across authorization, peer review, pharmacy, bill review and case management, while keeping clinical oversight and operational control.
- One accountable operating model
- Consistent decisions across every handoff
- Visibility from intake through closure
Built with the people who make the decisions.
Claimatix pairs workflow intelligence with experienced clinical review operations. Through our partnership with P&S Network, the technology stays connected to physician judgment at the moments that matter.
Explore a partnershipClaimatix
Workflow intelligence
P&S Network
Physician expertise
Start with one workflow. See the difference.
Connect a single decision pathway first, then expand once the value is visible.
Fewer preventable handoffs
Work keeps moving across clinical, payment and coordination teams without rebuilding your core systems.
Every decision traceable
Capture the evidence, reviewer, communication and next action behind each operational decision.
Smarter with every case
Workflow activity becomes structured operational intelligence your teams can use on the next claim.
Questions, answered.
Claimatix is a decision intelligence platform for workers' compensation. It connects utilization review, pharmacy benefit review, medical bill review, physician peer review and case management into one governed, traceable workflow.