Training Example: Stratacare – Review the Data, Give Your Score & Compare to the Real AI Evaluation

Stratacare

[H2] Intelligent solutions for a smoother claims process

We’re bridging the gap between injury and recovery with innovative solutions that streamline communication, reduce costs, and accelerate recovery.

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[H2] Casualty Claims Solutions and Services

By seamlessly integrating medical expertise, innovative technology, and strategic partnerships, we create a synergy that drives better outcomes for injured workers and significant cost savings for payers.

[H2] Our casualty claims solutions transform claims management:

[H2] Injury Reporting & Nurse Triage​

Our 24/7 injury reporting hotline ensures immediate attention to workplace incidents. Experienced nurses provide initial assessments and guide employees to appropriate care, helping reduce unnecessary emergency room visits and associated costs.

[H2] Intake and Processing

We streamline claim initiation with efficient data capture and validation processes. Our team ensures accurate information gathering, enabling prompt claim handling and reducing processing delays.

[H2] Nurse Case Management

Our skilled nurse case managers coordinate care and facilitate communication between all parties. They develop tailored return-to-work plans, optimizing recovery times and minimizing claim duration.

[H2] Bill Intake and Bill Review

We employ advanced technology to process medical bills quickly and accurately. Our comprehensive review process identifies potential savings opportunities while ensuring fair reimbursement for providers.

[H2] Medical Networks

Our extensive network of quality healthcare providers specialize in occupational injuries. We negotiate competitive rates to control costs without compromising the quality of care for injured workers.

[H2] Utilization Management

Medical professionals review treatment plans to ensure appropriate, evidence-based care. We work to prevent unnecessary procedures while facilitating timely and effective treatments for optimal outcomes.

[H2] Advanced Analytics

Leverage our advanced data analytics to gain insights into claim trends and performance metrics. Our customizable reports help identify areas for improvement and inform strategic decision-making.

[H2] +Pay Integrated Payments

Experience seamless, secure electronic payments to claim payees through our +Pay system. This solution accelerates reimbursement, reduces administrative costs, and enhances payee satisfaction.

[H2] Integrated Medical Bill Management for Auto

StrataCare offers a comprehensive suite of solutions designed to streamline processes, reduce costs, and ensure accurate payments in the complex world of auto injury claims. Our cutting-edge technology, combined with expert human oversight, delivers unparalleled efficiency and savings. From initial bill receipt to final payment, we provide end-to-end management that allows you to focus on what matters most – supporting injured claimants and resolving claims effectively.Explore our key services for auto claims:

[H2] Digital Mailroom Services

Our 24/7 injury reporting hotline ensures immediate attention to workplace incidents. Experienced nurses provide initial assessments and guide employees to appropriate care, helping to reduce unnecessary emergency room visits and associated costs.

[H2] Medical Bill Review

Our comprehensive medical bill review service combines cutting-edge technology with expert analysis. We scrutinize each bill for accuracy, compliance with state fee schedules, and adherence to treatment guidelines, maximizing savings while ensuring fair reimbursement.

[H2] Strataware® Medical Bill Review SaaS

Strataware® is our powerful software-as-a-service platform for medical bill review. It offers real-time processing, customizable workflows, and robust reporting capabilities, empowering your team to manage bills efficiently and effectively.

[H2] Cost Containment

We employ multiple strategies to control medical costs without compromising care quality. Our approach includes negotiation of provider discounts, identification of billing errors, and application of appropriate fee schedules and UCR (Usual, Customary, and Reasonable) reductions.

[H2] Clinical Review

Our team of experienced healthcare professionals conducts thorough clinical reviews of complex cases. We evaluate the necessity and appropriateness of treatments, ensuring that care aligns with evidence-based guidelines and facilitates optimal recovery outcomes.

[H2] Analytics

Harness the power of data with our advanced analytics tools and customizable reporting. Gain valuable insights into billing trends, provider performance, and cost drivers to inform strategic decisions and continually improve your medical cost management

[H2] Why Choose StrataCare

[H2] Flexible Deployment

Available as on-demand software (SaaS) or a full-service offering, you can decide which model best fits your organization’s needs.

[H2] Continuous Support

Our team is always available, ensuring you never face a claims challenge alone.

[H2] Innovation Meets Expertise

Our proprietary technology is powered by industry veterans with decades of experience.

[H2] Scalable Solutions

Whether you handle 100 or 100,000 claims annually, our services flex to meet your needs.

[H2] We Want to Hear From You

If you need to get in touch with a member of our care team, contact us at 1 (800) 225-9675 or click Contact Us.

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[H2] Regulatory Resources

[H2] Resource Links

[H2] Managed Care

[H2] California Medical Provider Networks

[H5] MPN Contact Information
[H5] CA MPN 2386
[H5] CA MPN 3032
[H5] CA MPN 2131
[H5] CA MPN 3031
[H5] CA MPN 3155
[H5] CA MPN Provider Resource Guide

[H2] All Managed Care States

Complaint Form

[H2] Utilization Review

[H2] North Carolina

North Carolina URA PlanNorth Carolina Peer Review Provider RosterNCIC Form 25 PR – Request for Preauthorization of Medical Treatment

[H2] Bill Review Contacts

[H2] Provider Bill Inquiries

[H5] [email protected]

[H2] Government Bill Inquiries

[H5] [email protected]

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[H2] Privacy Statement

A casual visitor who browses the MedRisk (which includes MedRisk’s subsidiaries, StrataCare and Medata) Portal is not required to reveal any personally identifiable information, such as name, address, or telephone number, nor is such information collected passively by electronic means. In order to use Portal products and services, however, registration is required, which requires the visitor to disclose personally identifiable information and customer information.Portal servers collect other information such as the make of a visitor’s browser software and the Internet domain name of the location from which the visitor enters. This information helps us diagnose technical problems and manage our sites by tracking user interests.The primary reason that we collect and maintain customer information and other personally identifiable information is to serve visitors and to administer our customer relationships. We may collect this information from a variety of sources and for a number of reasons:Information visitors specifically provide to us, such as personally identifiable information visitors provide to us in the registration process to help us identify visitors and to help us prevent unauthorized persons from accessing customer information and other personally identifiable information and the products and services that we make available to specific visitors for their use.Information about transactions by visitors as part of the Portal products and services, or other visitor experiences with MedRisk, such as the information we receive when a visitor requests that we schedule an appointment.Log files, where we track information about each visitor’s usage of the Portal’s products and services. We use this information as follows:To analyze trends;To administer the products and services;To track statistical information about how visitors use the Portal’s products and services; andTo gather broad demographic information for aggregate use.We also may collect various types of non-personally identifiable information to help us make your experience more enjoyable, measure site activity to identify future improvements that should be made and compile aggregate data to help serve site visitors better.  As you navigate through and interact with our Website, we may use automatic data collection technologies to collect certain information about your equipment, browsing actions and patterns, including (a) details of your visits to our Website, such as traffic data, location data, logs and other communication data and the resources that you access and use on the Website, or (b) information about your computer and internet connection, including your IP address, operating system and browser type. We may use your IP address to help prevent fraud, to help diagnose problems with our server, to gather broad demographic information, and to offer you products and services. Because there is not yet a common understanding of how to interpret web browser-based “Do Not Track” signals other than cookies, we do not currently respond to “Do Not Track” signals that are undefined.The information we collect automatically is statistical data and does not include personal information, but we may maintain it or associate it with personal information we collect in other ways or receive from third parties. It helps us to improve our Website and to deliver a better and more personalized service, such as enabling us to (a) estimate our audience size and usage patterns; (b) store information about your preferences, allowing us to customize our Website according to your individual interests; (c) speed up your searches; and (d) recognize you when you return to our Website.The technologies we use for this automatic data collection may include cookies, flash cookies, and/or web beacons, described below:Cookies (or browser cookies). A cookie is a small file placed on the hard drive of your computer. You may refuse to accept browser cookies by activating the appropriate setting on your browser. However, if you select this setting you may be unable to access certain parts of our Website. Unless you have adjusted your browser setting so that it will refuse cookies, our system will issue cookies when you direct your browser to our Website, allowing us to enhance your user experience.Flash Cookies. Certain features of our Website may use local stored objects (or Flash cookies) to collect and store information about your preferences and navigation to, from and on our Website. Flash cookies are not managed by the same browser settings as are used for browser cookies.Web Beacons. Emails and newsletters sent electronically, as well as Pages of our Website, may contain small electronic files known as web beacons (also referred to as clear gifs. pixel tags and single-pixel gifs) that permit MedRisk, for example, to count users who have visited those pages or opened an e-mail and for other related Website statistics (for example, recording the popularity of certain website content and verifying system and server integrity).If you visit this site with an open ID (such as Facebook), you may also be sharing and integrating data with third-party social media sites, and we may track aggregate data about the number of visits to this site with an open ID, the number of items “liked” on this site, or items on this site that you choose to share with a third-party social media site.Some content or applications, including advertisements, on the Website are served by third-parties, such as advertisers, ad networks and servers, content providers and application providers. These third parties may use cookies, alone or in conjunction with web beacons or other tracking technologies, to collect information about you when you use our website. The information they collect may be associated with your personal information or they may collect information, including personal information, about your online activities over time and across different websites and other online services. They may use this information to provide you with interest-based (behavioral) advertising or other targeted content.We do not control and are not liable for the actions of any third parties who we may promote. We pride ourselves in working with quality companies, but have no control over the actions of those third parties. While we are not liable for any of the actions of those third parties, you should feel free to give us feedback from time to time on your experiences with any third parties to whom we work with so that we may enhance our future service to all customers. If you have any questions about an advertisement or other targeted content, you should contact the responsible provider directly.You can set your browser to refuse all or some browser cookies, or to alert you when cookies are being sent. To learn how you can manage your Flash cookie settings, visit the Flash player settings page on Adobe’s website. If you disable or refuse cookies, please note that some parts of this site may then be inaccessible or not function properly. We do not control third parties’ collection or use of your information to serve interest-based advertising. However, these third parties may provide you with ways to choose not to have your information collected or used in this way. You can opt out of receiving targeted ads from members of the Network Advertising Initiative (“NAI”) on the NAI’s website.To gather information to improve MedRisk’s products and services, from time to time we may request information from visitors via voluntary participation in surveys or market research activities. The information that we request may include contact information (such as name and business address), and demographic information (such as ZIP code).

[H2] California Privacy Rights

Effective: August 24, 2023These California Privacy Rights supplement the information contained in the Privacy Policy for MedRisk and applies to certain residents of the State of California. The terms used in this Privacy Notice have the same meaning as the terms defined in the California Consumer Privacy Act (“CCPA”).
[H3] A Note About MedRisk as a Service Provider
This California Privacy Rights Notice for California residents applies to information that we collect in our capacity as a “business” under the CCPA, i.e., when we collect information on our own behalf. If you interact with MedRisk based on your relationship to one of our clients (e.g., your employer or insurance carrier), you should review such client’s privacy policy and send any questions or communications relating thereto directly to such client (including, without limitation, if you wish to exercise any rights available to you under the CCPA). We assume no responsibility to you or any other third party with respect to any obligations of our clients under the CCPA. If you are not certain whether we are acting as a service provider in your particular circumstance, please contact us using the contact information provided in this Privacy Notice.
[H3] What Personal Information We Collect and Disclose
In accordance with the CCPA, personal information is information that identifies, relates to, describes, is reasonably capable of being associated with, or could reasonably be linked, directly or indirectly, with a particular consumer or household. Personal information does not include information outside the scope of the CCPA such as:Health or medical information covered by the Health Insurance Portability Act of 1996 (HIPAA) and the California Confidentiality of Medical Information Act (CMIA);Personal Information covered by the Gramm-Leach-Bliley Act (GLBA), the Fair Credit Reporting Act (FCRA), the California Financial Information Privacy Act (FIPA), and the Driver’s Privacy Protection Act of 1994;Publicly available information or lawfully obtained, truthful information that is a matter of public concern;Publicly available information that is lawfully made available to the general public from federal, state, or local government records; andDe-identified or aggregated consumer information.The CCPA requires us to tell you what categories of personal information we sell, share or disclose. We do not sell and will not sell your personal information as that term is commonly understood. We also do not sell and will not sell your personal information, including the personal information of persons under 16 years of age, as that term is defined by the CCPA. When it is necessary for a business purpose, we may disclose your personal information to a customer, service provider or contractor, and we enter into a contract with the customer, service provider or contractor that limits how the information may be used and requires the customer or service provider to protect the confidentiality of the information.We may also transfer to a third party the personal information of a person as an asset that is part of a merger, acquisition, bankruptcy, or other transaction in which the third party assumes control of all or part of the MedRisk business.Please see the chart below to learn what categories of personal information we may have collected about California consumers within the preceding twelve months, the sources of and business purposes for that collection and the third parties, as that term is defined in the CCPA, to whom the information has been disclosed, if any.

CategoryExamplesSourcesBusiness Purpose for CollectionThird Parties to Whom Information is Disclosed
IdentifiersReal name, alias, postal address, unique personal identifier, online identifier, internet protocol address, email address, account name, or other similar identifiers, social security number, passport number and driver’s license number.Claimant, employee, employer, attorneys, medical providers, public records, insurance brokers
and agents.
Providing products or services. Responding to and administering insurance claims. Fulfilling obligations as an employer.
Performance of a contract. Compliance with state and federal laws.
Medical providers, employers, attorneys, regulators and government authorities, insurance companies, third party administrators, service providers, subsidiaries and affiliates.
Personal information
described in California Customer Records statute (Cal. Civ. Code §
1798.80(e))
Name, signature, social security number, physical characteristics or description, address, telephone number, passport number, driver’s license or state
identification card
number, financial information, insurance policy number, education, employment, employment history, medical and health information, and health insurance information.
Claimant, employee, employer, medical providers, public records,
attorneys, insurance companies, third party administrators.
Providing products or services, responding to and administering insurance claims. Fulfilling obligations as an employer. Compliance with state and federal laws.Medical providers, employer, attorneys, regulators and government authorities, insurance companies, third party administrators, service providers, subsidiaries and affiliates.
Characteristics of protected classifications under California or federal law.Age (40 years or older), race, color, ancestry, national origin, citizenship, religions or creed, marital status, medical condition, physical or mental disability, sex (including gender, gender identity, gender expression, pregnancy or childbirth and related medical conditions), sexual orientation, veteran or military status, or genetic information (including familial genetic information).
Claimant, employee, employer, medical providers, public records, insurance companies
and agents.
Providing products or services, responding to and administering insurance claims. Fulfilling obligations as an employer. Compliance with state and federal laws.Medical providers, employer, attorneys, regulators and government authorities, insurance companies, third party administrators, service providers, subsidiaries and affiliates.
Internet or other
electronic network activity
Browsing history, search history, information about a consumer’s interaction with a website, application, or advertisement.
Claimant, employeeFulfilling obligations as an employer and service provider.N/A
Sensory dataAudio, electronic, visual, thermal, olfactory, or similar informationClaimant, medical providers.Fulfilling obligations as an employer and service provider. Medical providers, employer, insurance companies, third party administrators, service providers, subsidiaries and affiliates.
Professional
or employment related information
Current or past employment history, performance
evaluations, disciplinary
records, investigations, awards, earnings, compensation and payroll records, benefit records, employment application, resume, background checks, contracts and agreements or termination records, leave documentation, medical records or workers compensation records.Claimant, employee, employer, public records.Fulfilling obligations as an employer and service provider. Compliance with state and federal law.Medical providers, employer, regulators and government authorities, Insurance companies, reinsurers, service providers.
Nonpublic
Education information (FERPA)
Education records directly related to a
student maintained by an educational institution or party acting on its behalf, such as grades, transcripts, class list, student schedules, student identification
codes, student financial information, or student disciplinary
records.
Claimant, employee, employer, public records.Fulfilling obligations as an employer and service provider.N/A
Inferences from other personal information to
create a profile
of a person
A person’s preferences, characteristics, psychological trends, predispositions, behavior, attitudes, intelligence, abilities and aptitudes.Claimant, Medical providersFulfilling obligations as an employer and service provider.Medical and service providers

[H3] Your Retention of Personal Information
The length of time that we retain personal information largely depends upon the purpose for which the information was collected rather than the category of the information as set forth in this Notice. When establishing retention periods, we consider applicable statutes of limitation and legal and regulatory requirements and guidelines. Personal information is generally retained for periods of time that permit the company to meet its legal and regulatory obligations.
[H3] Your Rights and Choices
The CCPA provides California residents with certain rights regarding their personal information. This chart describes those rights and certain limitations to those rights.

RightWhat This Means
NoticeAt or before the time your personal information is collected, you will be given or be able to access information regarding the categories of personal information to be collected, the purposes for which the categories of personal information will be used and whether that information is sold or shared.
AccessAt your verifiable request, but no more than twice in a twelve month period, we shall disclose to you: (1) the categories of personal information we have collected about you, (2) the categories of sources for the personal information we collected about you, (3) our business or commercial purpose for collecting, selling or sharing your personal information, (4) the categories of third parties to whom we disclose your personal information, (5) the specific pieces of information we have collected about you, (6) the categories of personal information disclosed about you for a business purpose and the categories of persons to whom your personal information was disclosed for a business purpose, and (7) if we sold or shared personal information, the categories of personal information sold or shared and the categories of third parties to whom it was sold or shared.
DeletionYou have the right to request that we delete any of your personal information that we collected from you, subject to certain exceptions. Once we receive and verify your request, we will delete (and direct our service providers and contractors to delete) your personal information from our records unless an exception applies. We may deny your request if retention of the information is necessary for us or our service providers to:
• Complete the transaction for which we collected the personal information, provide a good or service that you requested, take actions reasonably anticipated within the context of our ongoing business relationship with you, or otherwise perform our contract with you.
• Help to ensure security and integrity to the extent the use of your personal information is reasonably necessary and proportionate to that purpose. Debug to identify and repair errors that impair existing intended functionality.
• Exercise free speech, ensure the right of another consumer to exercise their free speech rights, or exercise another right provided for by law.
• Comply with the California Electronic Communications Privacy Act (Cal. Penal Code §1546 et seq.)
• Engage in public or peer reviewed scientific, historical, or statistical research that conforms or adheres to all other applicable ethics and privacy laws, when the information’s deletion is likely to render impossible or seriously impair the research’s completion, if you previously provided informed consent.
• Enable solely internal uses that are reasonably aligned with consumer expectations based on your relationship with us and compatible with the context in which you provided the information.
• Comply with a legal obligation.
• Or if it is the type of personal information that falls outside the scope of the CCPA, (HIPAA, CIMA, GLBA, or publicly available information).
Given the type of information that we collect and the purposes for which we collect it, in many instances we may not be able to delete your personal information because without that information we would be unable to provide the insurance services that we are obligated to provide to you. Each request to delete will be considered on an individual basis.
CorrectYou have the right to request that we correct inaccurate personal information about you, taking into account the nature of the personal information and the purposes of the processing of the personal information. After we receive and verify your request, we will use commercially reasonable efforts to correct the inaccurate personal information as directed by you.
Opt-Out of Sale or
Sharing
With some limitations, you may direct a business that sells or shares personal information to third parties not to sell or share the personal information to these third parties.
Opt-In to Sale or
Sharing
A business may not sell or share the personal information of persons less than sixteen years of age without their affirmative consent, and in the case of those less than thirteen years of age, the consent must come from a parent.
Limit Use of Sensitive
Personal Information
You may direct a business to limit the use of your sensitive personal information to that use which is necessary to perform the services or provide the goods reasonably expected by an average consumer who requests those goods or services and certain other limited uses as described in the CCPA and applicable regulations.
Non-DiscriminationWe will not discriminate against you for exercising your rights under the CCPA. Unless otherwise permitted by the CCPA we will not:
• Deny you goods or Service.
• Charge you different prices or rates for goods or services, including through granting discounts or other benefits, or imposing penalties.
• Provide a different level or quality of goods or services.
• Suggest that you will receive a different price or rate for goods or services or a different level or quality of goods or services.
Retaliate against you as an employee, applicant for employment or independent contractor for exercising your rights under the CCPA.

[H2] To Exercise Your Rights
[H3] To Opt-out of the Sale or Sharing of Your Personal Information
The CCPA gives consumers the right to direct a business that sells or shares personal information about the consumer to third parties not to sell or share the consumer’s personal information. We do not sell and will not sell your personal information as that term is commonly understood. We also do not sell and will not sell your personal information, as that term is defined by the CCPA. We do not share your personal information as that term is defined in the CCPA.
[H3] To Limit the Use of Sensitive Personal Information
The CCPA gives consumers the right to direct a business to limit the use of the consumer’s sensitive personal information to that use which is necessary to perform