Workers' Compensation · Case Management

Clinical intelligence at every stage of the claim

From intake to risk assessment: spend your time on patients, not on charts. SecondLook reads every complex chart with physician-grade depth, surfacing recovery barriers, treatment red flags, and return-to-work risk, then ranks your caseload so case managers act on the claims that need them.

Nurse Case ManagersClaims ExecsMedical Directors
app.secondlookhealth.ai
Prioritized work-list · 1,240 open claims
Claim #WC-482114-day gap in care · stalled recoveryHigh risk
Claim #WC-5093repeat imaging · possible over-utilizationMonitor
Claim #WC-4677PT on track · RTW projected 3 weeksOn track
HIPAA CompliantHIPAA Compliant
SOC 2SOC 2 Type II Certified
AIClosed-System AI
The challenge

Your hardest claims hide in plain sight

A small share of claims drives most of the cost, and they don't announce themselves. By the time a claim looks complex, the window to intervene has often closed. Manual review can't keep pace with the volume, so the cases that need a nurse most are the ones that slip.

What you get

From raw records to a prioritized work-list

The full capabilities chain behind every complex claim: structuring, hygiene, risk flags, and ranked work-lists, delivered to your team or via API into your systems.

Clinical structuring and record hygiene

Fragmented, duplicated records become a clean, attributed, chronological narrative, the foundation every downstream judgment is built on.

Risk flags and earlier intervention

Real-time flags on over-utilization, delayed care, and return-to-work risk, each with the clinical reasoning your team needs to act before costs escalate.

Prioritized work-lists

Your caseload ranked by clinical risk and exposure, so case managers spend their hours on the claims that move the number.

Consistent handoffs, scale without headcount

The same physician-grade read on every claim means consistent handoffs and growing caseloads without proportional staff: case managers on patients, not charts.

Across the claim

Clinical insight at every decision point

1

Intake

Records read and structured the moment they land.

2

Triage

Claims scored by clinical risk and exposure.

3

Monitor

Progression and red flags tracked as records arrive.

4

Intervene

Case managers act on the cases that need a clinical hand.

5

Resolve

Cleaner narratives speed settlement and reduce disputes.

Who uses this

One engine, framed for your team

Carriers & TPAs →

Translate the record into reserves, intervention, and resolution your adjusters can act on.

Managed Care Organizations →

Physician-grade depth on every complex claim, prioritized for your nurses.

85 → 25

Minutes per case

99%

Accuracy vs the customer’s own physicians

6.5× / 22×

Operational / total-cost ROI

Related use cases

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Talk to our team →