Insights
Clinical Oversight Reduces Claim Costs by Recommending Discharge Over Added PT
To control escalating therapy costs, a managed care organization implemented a system of regular reviews for additional physical therapy (PT) authorization requests. They sought a clinical partner with PT expertise to provide informed recommendations on whether to discharge patients or approve continued therapy.
Workers' Compensation Pharmacy Legislative and Regulatory End of Year Recap
6 MIN READ
New regulations, proposed legislation, and notable judicial developments made 2024 a significant year for workers' compensation pharmacy programs. For pharmacy benefit management (PBM) roles, staying on top of these changes is critical for compliance and operational efficiency. Here is a recap of some of the major developments in workers' compensation pharmacy we’re watching as we move into 2025.
Managing the Seismic Shift from Inpatient to Outpatient Physical Medicine Services
Learn how shifting rehabilitative care to outpatient services earlier in recovery impacts physical medicine networks and return-to-work outcomes in our insightful conversation with Kim Radcliffe of Enlyte.
Ask The Pharmacist: Preventing Tetanus in Workers’ Compensation
2 MIN READ
Tetanus is a serious infectious disease that can result from workplace injuries. Caused by spores of the bacterium Clostridium tetani, tetanus is often associated with rusty nails but these spores are found in many environments, including soil, dust and animal feces. All it takes for infection is a small cut, puncture wound, or scrape—common injuries in many workplaces.
Field Case Manager Delivers Early Full Duty Release
2 MIN READ
A successful recovery takes collaboration, consistency, and care. Discover how our swift action and focus on compliance helped a heavy equipment operator return to full duty 14 weeks faster than guidelines recommend, saving $12,000+ in indemnity and medical costs.
Price Opportunist List and Smart PA Program Drive Decrease in Topical Utilization and Spend
2 MIN READ
Struggling with skyrocketing medication costs despite stable volumes? One workers’ compensation carrier reduced spending on dermatological/topical medications from $232k to $50k and eliminated them from their Top 10 spend categories. Discover how Enlyte’s innovative solutions made it possible.
AuditPro Corrected Inflated Medical Billing
2 MIN READ
Technology and Expertise Driving Better Claims Outcomes
Mitchell simplifies and accelerates claims management and collision repair processes through the broadest range of technology solutions, networks, and partners in the P&C industry.
Learn MoreHelping Injured Workers Get Better, Faster.
Genex helps injured employees return to their jobs in a safe and efficient manner through compassionate case management while reducing total claim cost.
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