ClaimWise — STD Decision Assistant

Decision assistant for STD case managers. Approve, deny, pend, or escalate in seconds.

ClaimWise is a decision assistant built specifically for Short Term Disability and Leave of Absence case managers. Instead of juggling 6+ systems simultaneously, ClaimWise consolidates your most repetitive tasks into one browser panel: DECISION ASSISTANT - Approve, deny, pend, or escalate to medical review in seconds - Auto-generates copy-paste Salesforce notes for every decision - Flags behavioral health and complex conditions for clinician review DATE CALCULATOR - Instantly calculates benefit start date, FMLA exhaustion, paperwork deadlines, recertification dates, and eligibility - Checks FMLA eligibility based on tenure and hours worked - Covers federal FMLA plus California, New York, Washington, New Jersey, and Massachusetts state laws RTW TRACKER - Generates escalating return-to-work outreach messages by attempt count - Separate templates for employee and employer contact - Auto-generates Salesforce task notes for every outreach REFERENCE PANEL - FMLA eligibility rules at a glance - State leave law summaries - Common pend reasons library - Clinician referral triggers Built by someone in the benefits industry based on real case manager feedback. Carrier-neutral — works for any STD/LOA team.