Claims review

Move from chart packet to claim-ready review.

Sensatecs helps health insurance claims teams turn complex medical records into structured review, clearer medical context, and decision-ready findings for faster, more consistent claims decisions.

Claims operations team coordinating medical review priorities in a payer operations setting

Health insurance workflow

From claim intake to review-ready determination.

Every view follows the same principle: structure the record set, surface what matters, and keep the evidence available when your team needs it.

Move the claim forward with clarity, consistency, and control.
01

Ingest the full claim file

Bring uploaded records, hospital packets, prior authorization materials, clinical notes, labs, and supporting documents into one organized review view without manual file cleanup.

02

Review the summary

Surface all important clinical information including diagnoses, medications, history, utilization indicators, care needs, concerns, recommendations, and other relevant data in one easy-to-scan summary.

03

Route the next action

Move from review into the next claims step, including determination support, follow-up, medical review, documentation, or handoff with a clear operational path.

Claims settings

Built to support the broader health insurance review workflow.

The same structured review model supports claims teams across utilization review, prior authorization, and coverage-related decisions.

Utilization review

Prior authorization review

Medical necessity review

Concurrent and retrospective review

Appeals and redeterminations

Case management support