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At The Forum, the IAIABC's committees and councils discuss policy and administrat
Medical costs in workers’ compensation and auto claims continue to rise. While catastrophic claims and fee schedule changes draw attention, much of the financial pressure often stems from factors less visible: fragmented systems, delayed referrals, disconnected data and reactive decision-making.
In this new article from Risk and Insurance, Enlyte experts Michele Hibbert and Melissa Martinez address the alarming doubling of heat-related worker deaths over 25 years. Learn prevention strategies as OSHA oversight decreases, including building safety cultures and implementing nurse triage to protect workers from rising temperatures.
Executive VP Dave Torrence explores how fragmented systems drive cost leakage in P&C claims, and how integrating clinical oversight, pharmacy management, payment integrity and network strategy can improve visibility, strengthen decisions and improve outcomes while reducing total claim spend.
When medical bill review is managed by internal teams, performance depends on sustaining specialized expertise and the ability to scale operations in the face of turnover, volume volatility and unexpected disruptions. For many payers, as bill volumes fluctuate and labor pressures increase, sustaining consistent turnaround times and maximizing savings can place growing demands on internal teams.
Not all durable medical equipment (DME) referrals are completed at purchase. Some include warranties that need to be monitored and maintained, including items like wheelchairs, respiratory equipment, prosthetics and patient lifts.