Global Surgical Package Fraudulent Billing
5 MIN READ
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.
CPT Code Changes for 2018: Things to Look Out For
4 MIN READ
A new year means new Current Procedural Terminology (CPT) code changes! There are a total of 314 code changes in the 2018 code set, and with 2018 just around the corner, it’s time to start thinking about how these changes will impact the casualty industry.
Texas Farm Bureau Insurance Puts Customer Service in the Driver’s Seat with Improved Workflow Processing
For more than 50 years, families have relied on Texas Farm Bureau Insurance to help them manage risk in their everyday lives. The company occupies a unique market position, serving customer communities where people’s reputations are based on trust and agreements are often sealed with a handshake. Texas Farm Bureau has thrived by emphasizing high-touch, personalized service as an operational hallmark, inspiring many customers to traditionally hand down their memberships to offspring.
When, Why, and How to Use Nurse Review on Third Party Medical Claims
When third party auto casualty claims are extremely complex, for example, when multiple providers are treating a claimant, the claimant has pre-existing conditions or the claim has been open for an extended period of time, insurance carriers benefit by bringing in medical professionals to perform claim reviews. An organization of trained nurses can be an invaluable tool in a third party adjusters’ toolbox.
Will We See Human Interaction Disappear with AI in Insurance?
4 MIN READ
Artificial intelligence (AI) has the potential to profoundly impact the insurance industry. Although I would be challenged to explore all the potential use cases for it in a single blog post, I do want to take a look at how it is changing the way consumers interact with their insurance company and the ability of insurance companies to deliver optimal claims experiences—and ultimately, better outcomes.
Workers' Compensation Medical Price Index: Q2 2017
2 MIN READ
The National CPI for All Services as reported by the Bureau of Labor Statistics in August 2017 is 120.9, which reflects a 1.7 percent decrease since Q1 2017. For the same period of time, Q1 2017 to Q2 2017, the National Workers’ Compensation MPI decreased 2.8 percent and as August 2017, sits at 110.7. Since Q1 2006, the MPI has increased 10.7 percent while the National CPI for All Services increased 20.9 percent.
Top 10 Trends from the Mitchell 2016 P&C Conference
At the 2016 Mitchell Property and Casualty Conference, keynotes, breakouts and everything in between were focused on technology and social trends that are changing the way we interact with one another and do business. From augmented reality to information security, here are 10 of the many trends that were top of mind at the conference.
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