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Workers' Comp Case Study

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

1 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.
Workers' Comp Podcast

Rigorous vs. Permissive Utilization Review: Beyond the ‘Rubber Stamp’
Mitchell Conference

Mitchell 2018 mPower Conference

Join us for Mitchell’s premier customer conference, the 2018 Mitchell mPower Conference, an exclusive, three-day event specifically for insurers and collision repair executives.

WorkCompWire Article

WorkCompWire: Mariellen Blue: California Legislation May Elevate UR Processes for All

Depending on how effective these regulations are at achieving these objectives, it may follow that similar initiatives could be adopted across the country.
Workers' Comp Article

10 Things You Need To Know About California SB 1160

1 MIN READ

SB 1160 will implement major reforms to the California workers' compensation (WC) system.
Workers' Comp Podcast

Making Change Happen in WC: What’s Holding You Back?

Everyone’s looking for new ways to improve their work comp programs, but when it comes time to implement real changes, it’s not so easy. In today’s Inside Workers’ Comp, Ron Skrocki explains why change is a challenge.
WorkCompWire Article

WorkCompWire: UR Demands Raise New Questions About URO Programs

In her article, Cathy Glade examines the increasing complexities faced by Utilization Review Organizations (UROs) amid rising demands for expedited medical treatment approvals in workers' compensation cases.

WorkCompWire Article

WorkCompWire: Cathy Glade: Relieving the Adjuster's Burden Through Automated Technology

In her article, "Relieving the Adjuster’s Burden Through Automated Technology," Cathy Glade, RN, discusses how automation can streamline workers’ compensation claims by reducing administrative tasks for adjusters. She emphasizes that integrating automated systems facilitates quicker communication between adjusters and case managers, enabling timely interventions and more efficient claim resolutions.