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Intelligent Decision Support

Intelligent decision-support systems (IDS) augment the value of workflow automation systems. Basic IDS tools tend to take the form of business rules built into the automation process. However, some issues require an adjuster's review. BaseLine supports those situations by first automatically identifying and delivering appropriate reference material to assist the adjuster in responding to the topic with a decision based on data.  Second, by enabling automation to complete all the routine follow-ups from the decision.

Intelligent decisions depend on getting the right information at the right time.

The claim professional's world is built around hundreds of rules and regulations and thousands of terms that carry meaning regarding the compensability of a claim. Each of these has to be followed in the prescribed manner. While much of that can be processed by workflow automation technologies, some points require the professional's judgment. 


With the BaseLine Platform, we address those issues by pausing the system and elevating the case to the appropriate professional for a decision that requires their expertise. Our objective is to provide the claim professional with relevant information to recognize the issue and make a prompt, data-supported decision. Then they should move on to other work while technology processes the details.


We have integrated several proprietary knowledge systems and various third-party resources into the BaseLine platform. Subsequently, when BaseLine recognizes a decision is required from a claim professional, the system will pause its automation process and tee up the issue for the professional. For example, in the case of a medical request that cannot be auto-approved, the system will present the professional with the problem, the history of the case, and what the guidelines suggest for such a request. This allows the claim professional to quickly grasp the issue, make a prompt determination, and move on to the next case while the automation system processes the request.

BaseLine engages and supports human intervention when and where it is required, providing the best available decision support resources to secure the right decision at the right time.

The BaseLine Platform integrates several intelligent decision-support services designed to support the claims professional in dealing with the incredible volume of data required by the many rules and regulations governing the system.   While many clients use shared resources, each is unique in the resources it selects to support its needs based on the client's priorities and workflows.  BaseLine accommodates the uniqueness of each of our customers.

We've experienced that when we set the stage for our clients to do more, their clients and stakeholders are happier.  When they do it faster, costs come down, and margins go up.  This makes the clients, the executive suite, and the business development team much happier.  And, when you do it better, everyone is happier except your competitors because they lose clients. 

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