Claimatix / Blog
Perspectives on decision governance, clinical AI, workers' compensation operations and the infrastructure that connects them.
Utilization review · September 22, 2026 · 9 min read
California IMR data shows most utilization review denials survive on the merits, yet an untimely decision is invalid no matter how sound it is. Here is how the UR clock works, what the clinical literature says about delay, and five operating practices that protect it.
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Clinical AI · September 22, 2026 · 10 min read
California law already reserves medical necessity denials for licensed physicians, and regulators nationally are formalizing AI governance for insurers. What the automation bias literature says about AI-assisted review, a practical division of labor, and five questions to ask any vendor.
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Payment integrity · September 23, 2026 · 11 min read
Utilization review decides what care is owed; bill review decides what is paid. California law ties them together far more tightly than most operating models do. Where the seam leaks, what the research says about prices versus utilization, and how to instrument the link.
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