Rising Medical Solutions Debuts 'Ask Leah' Generative AI Agent to Transform Claims Management

Rising Medical Solutions, a national managed care firm, today announced the launch of Ask Leah, now available within the VISION customer platform as the company's first generative AI agent and the latest advancement in its broader portfolio of AI-enabled claims solutions.

Modern claims are shaped by thousands of data points, activities, and interactions. Ask Leah brings that information together into a single claim review and decision-support experience. Instead of piecing together a claim's story across disparate documents, systems, and vendors, claims professionals can quickly understand what's driving the claim. Unlike traditional summaries that simply condense information, Ask Leah organizes and interprets medical, financial, and claim data to help users evaluate claim progression and development, identify risk, and establish priorities.

"Claims professionals are drowning in data but starved for insight," said Jason Beans, CEO of Rising Medical Solutions. "Ask Leah doesn't just summarize a claim, it helps users understand what to do next. It flags the reserve that doesn't match reality, the new diagnosis that hasn't been formally accepted, the return-to-work plan that's gone stale. That's the difference between information and action."

Beyond the Claim Summary

The Ask Leah experience is built to answer more than "What happened?" It is designed around the questions that drive day-to-day claim decisions: How have things changed? Where are the risks? What needs attention now? What should happen next? Key capabilities include:

• Severity and risk indicators: surfaces chronicity concerns, pain management risk, comorbidity complexity, surgery likelihood, psychosocial barriers, litigation exposure, and return-to-work probability—all scored and explained in plain language
• Compensability assessment: highlights factors that warrant further review of compensability determinations, including newly identified body parts or diagnoses requiring adjuster evaluation
• Exposure and reserve intelligence: compares reserves on file against predictive benchmarks and identifies potential exposure drivers that warrant additional review
• Return-to-work optimization: presents functional restrictions, employer accommodation status, and vocational risk, paired with possible adjuster actions
• Vendor coordination: provides a real-time view of vendor involvement and claim activity, helping users coordinate care management, ancillary services, legal resources, and other claim stakeholders
• Immediate action panel: generates a due-dated list of issues and recommended next steps, helping claims professionals prioritize their attention where it can have the greatest impact

The Future of Ask Leah

Ask Leah extends Rising's AI capabilities within VISION through the introduction of agentic AI, creating a new way for claims professionals to engage more deeply with complex claim information. As an evolving claim review and decision-support experience, future enhancements will expand Leah's ability to provide guided claim support and conversational assistance, enabling users to ask questions, pressure-test scenarios, explore alternative outcomes, and apply their expertise in increasingly interactive ways.

Protected from the Start

Ask Leah was designed using the same data protection standards that govern the rest of VISION. All protected health information (PHI) processed by the solution remains within a secure, isolated, and controlled environment and is never used to train, fine-tune, or improve external AI models. The capability operates under the same rigorous security framework and independently audited controls that support Rising's HITRUST certification, ensuring clients can benefit from AI-powered insights while maintaining the privacy, security, and integrity of their sensitive claims data.

Why Leah: A Name That Carries Meaning

Ask Leah is named in honor of Leah, daughter of longtime Rising Customer Success associate Jennifer Liesch. Leah was a joyful child who loved big bows, sparkles, unicorns, dancing, and making friends wherever she went. After being diagnosed with an aggressive brain tumor, she faced extraordinary challenges with remarkable courage, positivity, and resilience. Though Leah passed away in 2021 at the age of eight, her spirit and example continue to inspire those who knew her.

"We're honored to carry her name forward, and we're committed to making sure Ask Leah takes care of our customers just as Leah's mother always has," Beans said.

Ask Leah is available now within VISION for Rising clients. To learn more or schedule a demonstration, visit www.risingms.com.