Complex Claims Need More Than a UR Determination

May 29, 2026

Complex claims require more than a utilization review determination. Learn how connecting UR with case management, pharmacy, peer review and clinical oversight helps claims teams identify risks, remove barriers and improve outcomes.

The Next Generation of Claim Handlers Is Forcing a Rethink of How Referral Management Gets Done

May 28, 2026

As experienced claim handlers retire, a new generation is reshaping referral management. Discover how automation and connected workflows reduce administrative burden and support faster claim outcomes.

Turning Retrospective Review Into a Competitive Advantage

May 26, 2026

In this Enlyte Envision podcast episode, host Tom Kerr interviews experts Roland Kratzer and Alex Rose about optimizing utilization review programs for auto casualty payers.

The Aging Workforce

Aging workforce strategies for workers’ comp help employers manage claim severity, injury prevention and return-to-work planning. Learn key risks.

Retail and Mail Order Prescriptions

May 18, 2026

Overall cost and utilization by claim were down in 2025 even with 6 of the top 10 therapeutic classes experiencing rising cost per script. Migraine medications rose by nearly 10%, representing the largest script cost gains driven in part by increases in brand Average Wholesale Price (AWP) including brand AWP for migraine medications increasing 2.4%. Utilization per claim also jumped in the migraine medication class (up 9.6%), while every other class within the top 10 (besides topicals, which rose 2.5%) experienced decreased utilization.