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Workers' Comp Article

Specialty Solutions Spotlight: How Physical Therapy Clinical Guidelines Help Drive Faster Recovery and Lower Claim Costs

3 MIN READ

Physical therapy (PT) plays a central role in recovery. But without clear targets, treatment can easily extend longer than necessary, delaying return to work and increasing costs. That’s where clinical guidelines come in. They provide benchmarks for treatment progression, expected visit counts, and documentation standards—all critical elements needed to ensure appropriate care, reduce friction, and keep claims moving forward.
Workers' Comp Podcast

Peter Rousmaniere Part 1: Comp’s Evolutions and Influencers

When you think of industry icons in workers’ comp, Peter Rousmaniere is among the select few at the top of the list. For more than 30 years, Peter has been a major influencer in workers’ comp, especially over the past couple of decades as a popular columnist. Last month, Peter announced his well-deserved retirement, so we asked him to join us on Inside Workers’ Comp to talk about his celebrated career and offer insights on the industry. The conversation was so profound that we made it into a two-parter. Here’s Part 1.
Workers' Comp Blog

What moved the state of Ohio to drop OxyContin® from their formulary?

3 MIN READ

The state of Ohio, among the hardest hit in the nation for opioid overdose deaths, has undertaken a number of measures to meet the crisis as it has evolved. A review of opioid use in the injured worker population, completed in 2011, revealed an alarming number (73%) were filling opioid prescriptions.1 A closed formulary, expanded access to antidote products (naloxone), and opioid focused prescribing guidelines have all followed since and have contributed to some reductions in prescribing and the prevalence of opioid use.
Mitchell Article

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.
Mitchell Article

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.
Workers' Comp Article

CMS Recovery Thresholds Update

1 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 Medicare Set-Aside services Genex provides.
Workers' Comp Article

CMS Recovery Thresholds Update

1 MIN READ

Keep current with new legislation and its potential effect on your organization.
Workers' Comp Blog

Overview of the 2019 Texas Department of Insurance Workers’ Compensation Network Report Card

5 MIN READ

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.