How One Carrier Saved $2M by Automating Utilization Review Decisions
At a large insurance carrier, adjusters were manually tracking utilization review (UR) determinations and cross-referencing them with incoming medical bills, often across multiple claims. Their traditional manual approach to UR was time-consuming, prone to human error and made it difficult to catch when providers billed for services that had previously been denied or exceeded the authorized limits. As a result, they paid for non-authorized treatments and lost productivity as their adjusters had to spend valuable time on administrative tasks instead of higher-priority responsibilities.
On the Hot Seat: Political Uncertainty Clouds Heat-Related Work Injury Measures
Heat-related work injuries are a growing concern in workers’ comp, but are lawmakers keeping up? This Enlyte Envision episode explores the regulatory and clinical sides of the issue — from proposed OSHA rules and state legislation to practical steps employers can take to protect workers and stay compliant, indoors and out.
Managing Michigan Auto No-Fault Claims with Confidence
2 MIN READ
Learn how Enlyte helps Michigan auto insurers manage no-fault claims with integrated utilization review, bill review, and field case management.
Ripple Effect: Potential Impacts of Tariffs and Proposed Medicaid Cuts on Workers’ Comp
Discover how U.S. trade tariffs and proposed Medicaid cuts could reshape workers’ comp costs and care access. Dave Torrence outlines key risks and strategies in WorkCompWire’s "Leaders Speak" article.
Proposed Utilization Review Amendments to California Workers' Compensation: What to Know
4 MIN READ
Explore the proposed changes to California Workers' Compensation regulations and their potential impacts on workers, employers, and the broader system. Stay informed about how these shifts could reshape the future of compensation policies in the state.
Inside the Digital Shift of New York Workers’ Compensation
5 MIN READ
Explore the innovative digital transformation of New York's workers' compensation system with the NY Workers' Compensation Board's 2024 conference highlights. Discover how the OnBoard: Limited Release system modernizes processes, enhances efficiency, and improves outcomes for stakeholders through real-time data access and an adaptive electronic system.
Seven Technology Features in Utilization Review Software to Control Medical Costs
3 MIN READ
Discover essential features of utilization review software that can help combat rising medical costs in workers' compensation.