This includes provisions to eliminate utilization review (UR) delays and inappropriate denials of care for injured workers, as well as prevent billions of dollars in WC billing fraud. Check out the 10 things you need to know about SB 1160 to stay ahead of the complex and evolving regulations
Sometimes the most innocuous conversations with family, friends and coworkers can lead to a major finding for medical billing fraud. Take the example of simply talking to your coworker in the next cube about a suspicious provider billing situation. To your surprise, you find out your coworker is having the same suspicion about the same provider on other auto first party claims. What ends up happening is a pervasive situation of intentional fraud uncovered by one conversation. This is exactly what occurred in identifying “Global Surgical Package Fraudulent” billing scenarios.
Average Length of Rental (LOR) for Q3 2017 landed at 12.1 days in the United States, an increase of just 0.2 days compared to Q3 2016. This is a continuation of the general course throughout the calendar year, although a few months produced measurable increases. Once again, there was very little consistency between regions and states, suggesting that the quarterly result for the U.S. is not reflective of a genuine national trend.
Average wholesale prices in October were down only modestly month-over-month and were up year-over-year, bolstered by lingering impacts from hurricanes Harvey and Irma.
The initial average appraisal value, calculated by combining data from all first and third-party repairable vehicle appraisals uploaded through Mitchell systems in Q3 2017, was $3,019, $16 less than this same period last year. However, continued development suggests a final Q3 2017 average appraisal value of $3,043, which represents an increase over the same quarter last year.
Total loss data for both vehicle age and actual cash value of total loss vehicles processed through Mitchell servers.
The average gross initial appraisal value, calculated by combining data from all first and third party repairable vehicle appraisals uploaded through Mitchell Canadian systems in Q3 2017, was $4,003 - a $178 decrease from Q3 2016. Factoring for development yields an anticipated increase to $4,042.