Looking for Genex? You’re in the right place! All the injury management resources you have come to expect from Genex are available here at Enlyte. Be sure to check out our adjuster resource hub for more!
Early Risk Identification
Know Exactly When to Deploy Clinical Resources with GenexEngage
GenexEngage is an AI-driven risk identification and proactive monitoring platform that scores claims early and reassesses risk throughout the life of the claim so you engage clinical resources on the right claims at the right time.
Measurable Impact with GenexEngage
27%
Reduction in Case Duration
14%
Higher Return-to-work Success Rate
53%
Faster Case Assignment (18 Days Sooner)
Enhancing Efficiency with Predictive Analytics
GenexEngage transforms case management through predictive and demonstrated risk modeling, harnessing integrated data from claims, medical and pharmacy records. Our capability employs a machine-learning model to pinpoint potential risks at the earliest stages of a claim, facilitating prompt and precise allocation of clinical resources. Watch our video to learn more.
Benefits
Find high-risk claims before they spiral
Predictive risk scoring starts with first notice of loss and the initial claim feed, helping you spot early intervention opportunities in the first 90 days.
Catch “maturing” risk with daily proactive monitoring
Demonstrated risk alerts use integrated claim, medical, and pharmacy utilization data to detect inappropriate, excessive or escalating care.
Run a leaner, smarter clinical model
Route telephonic case management and field resources where they’ll have the greatest outcomes, reducing unnecessary intervention and helping expedite RTW.
Features
Machine-learning risk model (built on 50K+ claim records)
So you get consistent, data-backed triage across your program, not inconsistent decision-making.
Customizable rules engine
So risk identification matches your program goals and workflows.
Tracks triage activity + recommendations
So you can see what was flagged, what was recommended and what decisions were made.
How It Works
- Identify risk early with predictive scoring
- Engage the right clinical support based on acuity and attributes
- Impact outcomes with program analytics and ongoing monitoring
Frequently Asked Questions about GenexEngage
What is GenexEngage?
An AI-driven platform that identifies and proactively monitors claim risk across the life of a claim using integrated claims, medical and pharmacy data.
How is this different from rules-based flags?
It combines predictive scoring early with ongoing “demonstrated risk” monitoring from utilization signals, not just static triggers.
When does it identify risk?
It can score risk from first notice of loss and continue monitoring daily as the claim develops.
What decisions does it support?
Which claims should get early intervention or deferred TCM intervention, or field case management based on claim attributes and risk.
Does it integrate with my claims system?
Yes, GenexEngage is designed to integrate with existing claim feeds to reduce resource effort.
Related Insights
See How GenexEngage Fits Your Workflow
Let's collaborate on a solution that fits your organization’s needs. Schedule a consultation to explore how our clinical expertise and AI-driven approach can support your organization and improve outcomes.