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Workers' Comp Case Study

How One Carrier Saved $2M by Automating Utilization Review Decisions

8 MIN READ

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.
Auto Casualty Article

The Power of Streamlined IT Investment: Simplifying Claims Technology Implementation

4 MIN READ

This is the fourth article in a seven-part series that highlights how technology and solution integration can result in improved claim outcomes. Click to read the first, second and third articles in the series. In the past decade or so, the world has undergone tremendous technological transformation. For example, in 2008, only 139 million smartphones were sold, compared to 1.56 billion in 2018, according to Statista.
Workers' Comp Case Study

Starbucks Coffee Company

4 MIN READ

Genex Services: A Key Service Provider in an Award-winning Strategy “Genex’s dedicated nurse case management team has been instrumental in helping us improve outcomes, and their team

Workers' Comp Article

The Art of Creating a Physician Peer Review Panel: Contracting and Training

4 MIN READ

In part I of the series, we discussed the first steps of developing a physician peer review panel including determining candidates for the panel and some basic steps to credentialing, including validating state licenses, experience, knowledge and other factors.
Workers' Comp Article

State-Mandated Formulary Implementation: Four Key Considerations

8 MIN READ

The state-mandated formulary wave is poised to continue in 2019. In just the first month of the year, an additional three states published draft or final formulary rules (New York, Montana and Kentucky). These laws provide guidance on the prescribing of medications to injured workers and are effective in addressing major workers’ compensation issues.
Mitchell Conference

Guidewire Connections 2019

Guidewire Connections is the conference for people who u
Workers' Comp Article

The Art of Creating a Physician Peer Review Panel - Part 1

4 MIN READ

Creating a physician peer review panel is like solving a puzzle – it comes together only after reviewing the landscape, discerning what is important, and identifying what resources are available. As in most industries, a problem or opportunity in the workers’ compensation arena first presents itself, then team members come together to share ideas and collaborate on possible solutions.
Mitchell Article

WCF Insurance Proves that Doing the Right Thing is Good for Business

For more than 100 years, WCF Insurance has been protecting both workers and employers as Utah’s premier workers’ compensation insurance provider. Although the company has come a long way from its beginnings in 1917, its dedication to creating strong communities has remained constant.