Solutions for Workers' Compensation and Auto Claims
your path to success
Introducing a curated resource hub where insights and strategies await to conquer your toughest claims challenges.
Throughout this year, we will dive deep into key themes designed to ignite recovery, conquer claims chaos, and tackle costs with precision and purpose.
- Ignite Recovery. Get ready to activate powerful strategies that prevent delayed recovery and accelerate successful outcomes.
- Conquer Claims Chaos. As you strive to balance stretched resources against growing demands, we will explore how advancements in automation and AI can modernize your adjusters’ desktops and unlock new opportunities for efficiencies throughout your program.
- Tackle Costs and Awaken Results (Coming in Q4). Get an inside look at how a holistic approach across the claims continuum unleashes new opportunities to realize better outcomes while capturing every savings opportunity.
recovery
Delayed recovery not only impacts your organization's financial stability, but also greatly affects people's well-being and productivity. As such, it is imperative for payers to take a proactive and innovative claims management approach. Together, we can achieve a future where every injured individual receives the support he or she needs to recover and thrive. Continue reading to discover the key strategies that can ignite recovery and transform the claims journey.
From Setback to Comeback: Effective Solutions for Delayed Recovery
Learn how to effectively ignite workers' compensation recovery by addressing some of the biggest return-to-work obstacles, including mental health comorbidities, social factors, and delayed intervention. See how data-driven strategies lead to successful claims management and faster employee recovery.
Practical Application of Behavioral Coaching Techniques
An injured employee navigating complex medical and psychological challenges received crucial support from a telephonic case manager. By using behavioral coaching—active listening, cognitive strategies, and tailored education—the case manager built trust and overcame challenges like negative thoughts and missed appointments. This personalized approach empowered the employee to take an active role in his recovery, ensuring successful return to work and significant cost savings.
Resilience Redefines Results
June 10 | 12:00 pm EST
Presented by Tammy Bradly and Dr. Michael Lacroix (The Hartford)
Resilience is a powerful factor in improving workers' compensation outcomes, from aiding recovery to enhancing return-to-work success. This webinar examines how resilience influences the mental and physical well-being of injured employees, enabling faster and more effective recoveries. Gain practical insights into strategies that empower employees, reduce the duration of claims, and foster workplace engagement after recovery. Learn how to integrate resilience into claims processes to build a supportive foundation for long-term results.
Expert Interview series How Top Claims Teams Catch Risk Before Costs Escalate
In this podcast, Rebecca Morgan and Jim Harris share how leading organizations are transforming raw claim data into actionable intelligence that prevents delays and controls spend.
Additional Resources to Ignite Recovery
The key to preventing delayed recovery lies in using holistic information to identify risk factors throughout the claim's lifecycle. The following insights demonstrate how resource integration addresses claims risk and promotes swift recovery.
Discharge Planning - A Vital Component for RTW
Discover how effective discharge planning ignites recovery, elevates care, and accelerates an injured employee's return to work.
Clinical Oversight Reduces Claim Costs by Recommending Discharge Over Added PT
See how one organization focused on clinical recommendations to get 23% of its physical therapy claims back to work sooner and saved 53% in therapy costs.
Focusing On a Physical Work Injury Could Mean Missing a Mental Health Challenge
This article emphasizes the importance of taking a whole-person approach to recovery from work-related injuries by addressing both physical and mental health challenges using tools like active listening and behavioral coaching.
Health Coaching and Employee Engagement
Gain insight into how health coaching and education empower injured employees with the tools and support they need to actively engage in their recovery and return to work successfully.
Unbundled Early Intervention Program Leads to Greater Transparency
A large self-insured employer partnered with Enlyte to create a customized early intervention telephonic case management program after wanting to unbundle these services from their third-party administrator. After implementing the program the company achieved significant results including 91% return-to-work.
Unlock the Full Potential of State-Certified Managed Care Plans
Learn how Coventry’s Managed Care Plans deliver expert workers’ compensation solutions with broad network coverage, cost management, and a focus on quality care and early intervention to ensure injured employees return to work quickly and safely.
A Comprehensive Guide to Using an Outcomes-based Network
Learn how Coventry's Outcomes-based Network (OBN) uses data to identify top providers, reducing costs, claim durations, and improving return-to-work outcomes for workers' compensation payers.
Reducing Opioid Utilization in High MED Claims
This eBook examines a personalized approach to opioid management, including strategies to reduce inappropriate use and recommendations for addressing high-MED utilization.
Clinical and Pharmaceutical Best Practices for PTSD
As more states recognize mental injuries claims professionals need to prepare for managing them. This podcast covers the criteria for a successful post-traumatic stress disorder diagnosis.
Decoding Functional Restoration Programs: Ensuring Accurate Billing Practices
Functional Restoration Programs (FRP) help injured employees get back to work, and understanding their billing can ensure you are reimbursing providers only for the specific treatment and intervention delivered.
Integrating Mental Health in Workers’ Comp
Discover why mental health is crucial for the recovery of injured employees and how it shapes outcomes for both employees and organizations.
claims chaos
Casualty payers continue to face mounting pressures, with rising costs that strain resources and threaten profitability. But beyond the battle against escalating expenses lies the pressing need to confront inefficiencies and inconsistencies that often create chaos in auto and workers’ comp processes. To stay competitive and meet evolving stakeholder expectations, payers must go beyond incremental fixes. Read on to discover how you can unlock new opportunities to reduce complexity in claims management.
Three Ways to Eliminate Chaos in the Auto Claims Process
Learn how to eliminate complexity in the auto claims process by addressing key drivers of chaos: escalating social inflation, surging claim severity, and increasingly sophisticated plaintiff attorney tactics. This white paper outlines three proven solutions that reduce friction across platforms, boost adjusters’ negotiation leverage, enhance settlement accuracy, and enable adjusters to review complex medical records in minutes.
How One Referral Can Simplify the Entire Coordination Process
Learn how Apricus transformed fragmented care coordination into a streamlined, clinically guided solution. This case study shows how one referral can reduce adjuster workload by 100+ hours, cut claim costs by thousands, shorten recovery timelines, and deliver a better experience for injured employees.
COMING SOON
Expert Interview Series with Rebecca Morgan and Jim Harris
Tame the Chaos: How to Use Data to Bring Structure to Claims
Data visualization, real-time analytics, AI, and system integrations transform overwhelming claims data into clear, actionable insights. Discover how having the right data at the right time can help you strengthen decision-making, reduce errors, simplify processes, and streamline claims workflows for greater efficiency.
Automate the Chaos: AI, Dashboards, and the Future of Claims
Get a deep dive into how automation, AI, and dynamic dashboards are shaping the future of claims management. Learn how these advanced technologies are accelerating insights, enhancing productivity, uncovering key trends, and empowering teams to deliver stronger outcomes.
Additional Resources to Conquer Claims Chaos
To stay competitive in a high-pressure environment, casualty payers must move beyond incremental fixes and tackle inefficiencies head-on. These resources will unlock strategies you can implement to reduce complexity and tame claim chaos.
Vertical Integration of Data and Clinical Services to Improve Physical Medicine Outcomes
Explore how aligning clinical expertise with data-driven insights can eliminate inefficiencies, improve care consistency and drive stronger return-to-work outcomes.
Focusing On a Physical Work Injury Could Mean Missing a Mental Health Challenge
This article emphasizes the importance of taking a whole-person approach to recovery from work-related injuries by addressing both physical and mental health challenges using tools like active listening and behavioral coaching.
Genex Engage Video
In this video, you'll discover how to use predictive and demonstrated risk modeling to identify key data signals and deploy clinical resources more effectively.
Gain Visibility and Control with the Medical Spend Dashboard
The Enlyte Medical Spend Dashboard transforms complex workers' compensation billing data into clear, actionable visuals, enabling decision makers to learn where medical dollars are being allocated in real-time and how to effectively manage their program through customizable metrics.
Managing Michigan Auto No-Fault Claims with Confidence
This article outlines an integrated approach—combining utilization review, bill review, and field case management—helps Michigan auto insurers manage no-fault claims more effectively.
Combatting New Jersey Auto Casualty Challenges
In this podcast, Enlyte's Ben Roberts explores how NJ DPR+ addresses the complexities of New Jersey's auto casualty claims by streamlining clinical and administrative processes to enhance efficiency and compliance.
ePay: A Simple Solution to Improve Claims Efficiency
In this podcast, Enlyte's Sanjog Patel discusses how transitioning from outdated paper-based processes to modern electronic payment solutions can significantly enhance claims efficiency by streamlining workflows and reducing costs.
The Coventry VIP Program
Learn how the Coventry VIP Program drives efficiencies and reduces administrative burden through proactive provider support.
How Can You Find the Right Provider for the Best Care?
Learn how channeling tools simplify provider selection for adjusters, case managers, and employees by reducing administrative burden, boosting operational efficiency, and keeping claims on track.
Price Opportunist List and Smart PA Program Drive Decrease in Topical Utilization and Spend
Workers’ comp continues to see increases in both the cost and utilization of topicals. See how identifying this low-volume, high-cost price outlier enabled a payer to leverage smart adjudication functionality to decrease both topical utilization and spend.
Enlyte Pharmacy Experts Speak on Turning Challenges Into Opportunities
Payers face numerous pharmacy utilization and cost challenges. In this Enlytening Conversation we dig deeper into proactive opportunities to address these challenges through identification, regulation, analytics, and continually reevaluating outcomes.
The Heart of the Challenge: The Role of Direction of Care in Managing Workers' Compensation Costs
Learn how a direction of care approach to pharmacy could allow payers to negotiate better network rates and gain leverage to weed out bad actors and take advantage of clinical controls and best practices.
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Fueling the Mission to Protect Dreams and Restore Lives
Check out the newest product innovations and insights that help optimize each step of the claims journey to unleash your path to success.
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The path to claims transformation is not one-size-fits-all—it requires tailored insights and actionable tools that respond to your unique challenges. That’s why this resource hub is built to grow alongside you, with timely updates, data-driven best practices, and proven methods for success. Subscribe to the series today!