Testing a completed file means establishing what it was meant to meet.
Before grading begins, someone must determine which requirements applied to that claim on that date — and check what the file evidences against each one.
Outcomer prepares the file for them.
Your auditor opens a Case Orientation Report, not a raw file.
Every requirement the claim engaged — the statutory provisions in force at the time, and your own QA framework and handling standards — identified for consideration, with what the file evidences set against each one. It states the position on each requirement. It never reaches the grade.
Two rails, clearly separated. The statutory requirements for the jurisdictions you write in, and your own handling standards alongside them. Your auditor can see at a glance which findings carry statutory exposure and which are your house rules.
It reports the file, not the auditor. It states what the record shows and what it does not — never what anyone did or decided.
Every file is tested against the requirements in force when it was worked. A file reviewed in 2023 is tested against the 2023 standard, so a change to the framework never alters the position on a file already tested.
Second-line review is nearer to pure preparation than first-line work is — most of the time goes on reconstructing what the file was meant to meet before any judgement is formed. Outcomer does that work. That time returns to the testing you employ them to do. Judgement minutes are unchanged; every minute saved is preparation.
An estimated 43% less time on each claim —
around 75% more capacity from the same team.
Estimated from a task-level decomposition of testing one completed indemnity file against the standard in force when it was worked, taking the conservative end of each range and including the time to run and read the report. Judgement minutes are unchanged — the saving is all preparation. These are our figures, not measurements on your claims; we go through the working against your own case timings in the demo.
The statutory requirements for the jurisdictions you test, and your own QA framework, loaded alongside them under NDA. Your standards sit in your own configuration only. Nothing derived from them enters the shared regulatory corpus, and no other client’s configuration can draw on them.
Every provision a claim of that type engaged, with the version in force at the date it was worked — so a 2021 file is tested against the 2021 rules, not today’s. You review the whole set and sign it off.
Your own testing standards, scoring criteria and handling requirements, decomposed into requirements and set alongside the statute rather than merged with it. You confirm the rendering represents your framework.
Maintenance is agreed at the same time — how the matrix stays current, how you tell us when your own standards change, and how each update is recorded. Requirements are date-gated, so a claim from 2021 is examined against the rules as they stood in 2021.
An orientation layer that sits alongside your claims administration system. Outcomer does not replace or write to it. It reads the file and states the position; your auditors decide and update the record. No migration, no change to how claims are administered.
Outcomer deploys as a container inside your own environment. The software and the model run in your estate, and nothing about the claim leaves your tenancy.
Built to fit your claims workflow. Outcomer can operate as a standalone workflow during evaluation, or integrate with your existing claims-management environment so the Case Orientation Report becomes another part of the auditor’s existing workflow.
We will show you a Case Orientation Report produced against a completed file, walk through how the matrix is configured and signed off, and go through the capacity estimate against your own testing timings.