When Do You Need an MSA?
This article is authored by guest blogger, Deborah Robinson Stewart, National Manager of Medicare Set-Asides, Genex Services. In its simplest form, the Medicare Set-Aside (MSA) is a pool of funding reserved for future accident-related treatment once a workers’ compensation case is settled. However, because of its complex nature, some employers will go the MSA route when there are better options available, or they’ll incorrectly believe a settlement agreement will cover these expenses and decide not to pursue.
Three Workers' Comp Trends & How to Manage Them
In 2019, we have seen a variety of workers’ compensation trends come into even sharper focus, from electronic billing to medical marijuana to the aging workforce. Identifying and effectively managing trends and changes in the workers’ compensation industry can help claims organizations to make continuous operational improvements that can ultimately have a positive effect on their bottom lines and more importantly on positive outcomes for injured employees. Below, we have explored three significant trends affecting the industry today and outlined key tips for effectively managing them.
CMS Recovery Thresholds Update
Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the Medicare Set-Aside services Genex provides.
CMS Recovery Thresholds Update
Keep current with new legislation and its potential effect on your organization.
Overview of the 2019 Texas Department of Insurance Workers’ Compensation Network Report Card
The Texas Department of Insurance recently released its annual Workers’ Compensation Network Report Card. The 2019 Report Card includes medical cost and utilization measures for 17 workers’ compensation health care networks (HCNs), including the Coventry HCN, First Health HCN, and several other HCNs supported by Coventry. Various measures were calculated for injuries occurring between June 1, 2017 and May 31, 2018.
Medicare Secondary Payer Updates
Miscellaneous Medicare Secondary Payer Clarifications and a Reminder for Non-Group Health Plan (NGHP) Responsible Reporting Entities (RREs) Regarding Medicare Beneficiary Identifier (MBI) Reporting
Pharmacy Nurse – When specialized attention is what’s needed
Workers’ comp pharmacy costs represent approximately 18% of total medical spend. That translates to $5 billion in pharmacy spend nationwide.1 Most employers and payors utilize Pharmacy Benefit Managers (PBMs) which offer an excellent line of defense in managing these ever-increasing pharmacy costs. But PBMs, by design, only manage the pharmacy related aspects of a claim. What if you could extend the reach of your PBM by combining it with the knowledge, care and one-on-one delivery model used in case management? With a pharmacy nurse, you can.
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