ClaimWise — STD Decision Assistant

About

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.