Rigorous vs. Permissive UR — Going Beyond the ‘Comfort Level’

… way with claims examiners. And then, of course, you've got escalation to a specialty match physician for those treatments that you really think need that rigor or need that level of …

The Insurance Workforce: How to Maintain Knowledge & Set New Employees up for Success

… is your textbook?” It turned out it was all online! We need to digitize our training to help match the younger generation’s experiences. Note that digitizing doesn’t mean just popping up a … Equip employees with the technology they need to perform their job function well, and match the way they use technology in their personal lives. Change the way you recruit talent to …

Specialty Solutions Spotlight: What Adjusters Need to Know About Foot and Ankle Injuries in Workers’ Comp

… and prolong recovery. When surgery is warranted, postoperative expectations should match procedure complexity; for example, after plantar fasciitis surgery, about six weeks of …

Inside Texas Workers’ Comp: How Certified Health Care Networks Shape Outcomes

… certified Texas HCNs, Coventry supports or directly certifies 17. Each program is designed to match the goals of its target injured employee population, whether that’s faster RTW, better …

Supporting an Aging Workforce Through Ergonomics

… and proven solution to assist with this growing concern. By designing environments that match the needs of older employees, you can reduce injuries, retain talent, and increase …

5 Ways to Use Visual Reporting Effectively to Improve Claim Outcomes

… are available for review. It also allows companies to focus in on the areas that specifically match their business needs, making it easier to look at relevant data that can help make … trending upward that they might not have looked at otherwise. Many companies only look at the top-10 or top-20 procedure codes, but visual reports can give companies more insight into other procedure …

Enlyte Experts Discuss the Benefit of a Holistic Approach to Pharmacy

… a typical bill review process, you know, apply PPO discounts, and then have all the EOR codes match and be compliant, you know, for those denials. So it really is a challenge, and it, you …

Average Length of Rental for Repairable Vehicles: Q4 2022

… Yoswick, Editor of the weekly CRASH Network newsletter, remarked: “The overall trends in LOR match up with what we saw happen with the backlog of work that repairers reported in our Q4 … Editor of the weekly CRASH Network newsletter in the US, remarked: “The overall trends in LOR match up with what we saw happen with the backlog of work that repairers reported in our Q4 …

Key Trends in Big Data for Property & Casualty Industries

Mitchell Collision Repair Industry Data: Q2 2017

New Hazards and Opportunities for Insurers in the Internet of Things

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

… way with claims examiners. And then, of course, you've got escalation to a specialty match physician for those treatments that you really think need that rigor or need that level of …

Ask The Pharmacist: 5 Medication-Related Fraud Signs Work Comp Adjusters Should Know

… and involve the right clinical or compliance resources. When a medication doesn’t appear to match the accepted injury, treatment plan or claim history consider the following:  …

Functional Capacity Evaluation (FCE) Frequently Asked Questions

… Analysis of how the individual's current abilities match their job requirements. …

Using Data Analytics to Optimize Insurance Claims Management

… cost-containment strategy. If we want to capitalize on the data available to us, we need to match it up with human insight. Having the right personnel performing data analysis—and taking …

August 2022 Utilization Review Compliance Update

… days rather than calendar days; additional language was added to make the time periods match. …

Catastrophic Claims Often Require Nuanced Solutions

… a facility for further care, recovery and rehabilitation, the specialty service provider will match the type of injury to the best facility. The best specialty service providers will offer a …

Using Risk Prediction Technology to Move Claims Forward

… if there're multiple diagnoses, verifying that with the claims adjuster that those diagnoses match up. Then, with all of that detail, they're able to provide the adjusters with a treatment …

Work Comp Guidelines for COVID-19

… expanded this so much more and we were very grateful that we reworked our plans and got on top of this as quickly as we did. …

Turning Retrospective Review Into a Competitive Advantage

… denials but also high appeals, then your program may be just too aggressive and not really match the demands of the jurisdiction. So, you want to make sure that your denials are reasonable …

Alternative Transitional Duty: A Win-Win for Employee, Employer and Community

… We then have a professional vocational counselor look at that, make sure those restrictions match up with the job, and then we make the job offer. We send out a written job offer via …

The New Standard for Proper and Safe Repairs

End-to-End Claim Insight: Identifying Risk Early to Protect Outcomes and Cost

… activates a repeatable intervention playbook. Once teams identify elevated risk, they should match the response to the level of severity or complexity, with clear ownership, timelines, and …

Are All Electronic Provider Payment Solutions the Same?

… reductions that are taking place along the way. So, most of the time, the paid amount may not match the invoiced amount. And so, it creates an uncanny importance on the reconciliation data. …

What is Ticket to Work?

… or openings as well as helping them learn how to look for work and to find opportunities that match their needs. Additionally, advice on ADAAA requests. Some people may feel it’s necessary to …

What is Ticket to Work?

… or openings as well as helping them learn how to look for work and to find opportunities that match their needs. Additionally, advice on ADAAA requests. Some people may feel it’s necessary to …

Demystifying the MSA

… they have to fill out the forms and it has the codes on it. If those codes are a positive match, that could create a conditional payment post‑settlement, which is something that then …

Independence Through Home Modification

… And it’s not too much. But there are times where we’ve had to maybe paint or stain a ramp to match the exteriors of other buildings. If they have a deck, we may have to just make sure that …