CMS Releases Version 2.8 of WCMSA Reference Guide
2 MIN READ
Keep current with new legislation and its potential effect on your organization.
Topical Trend Differences: Understanding Drug Mix
1 MIN READ
Topical medication cost and utilization continue to decrease in the managed population. However, in the unmanaged space we continue to see year-over-year increases in both cost and utilization. Understanding the differences in the types of topical medications dominating each space can help us to target pharmaceutical management strategies that weed out price opportunists and ensure the most appropriate care.
Making the Case for Nurse Case Managers
3 MIN READ
Nurse case managers play an influential role in an injured worker’s recovery, but if someone asked you, “What do nurse case managers do?” in more detail, what would you say? For National Case Management Week, we spoke with Mitchell Nurse Case Managers, Donna Battle, RN, BSN; and Sandra Sanders, RN, BSN, and Mitchell Medical Director, Dr. Zenia Cortes who shared their thoughts on the field of workers’ compensation case management.
StateWatch: Bill Review October 2018
2 MIN READ
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 bill review services Genex provides.
2019 CMS Medicare Payments: Proposed Changes and What They Mean for P&C Insurers
Several states in auto and workers’ compensation claims administration have adopted the Centers of Medicare and Medicaid Services’ (CMS) fee schedules and/or rules for payment of claims. The methodologies employed by CMS in provider billing and payment are typically either mandated by statute or become standards for appropriate billing and payment of claims. When Medicare adds new codes or proposes changes to fee schedules, Mitchell prepares for these changes by reviewing the proposed changes and how they could affect the Property and Casualty industry.
Before You Choose a PBM, do the Math
11 MIN READ
Cost is black & white Price alone isn’t. Your PBM must also control utilization or you’ll be seeing red.
Five Initial Evaluation Issues That May Delay Return to Work
When there’s a return to work delay, practitioners often look for problems that occurred during the course of treatment. However, as Mariellen Blue, Genex’s National Director of Case Management Services, tells us in today’s Inside Workers’ Comp, you may have to go back a little further in the recovery plan to find the answer. Check out the five reasons why the initial evaluation may be the culprit.