Article

2020 in Hindsight: Clinical Trends and Predictions

… reshaping the data we used in this review. Therefore, we will provide a quick overview of how certain changes during the pandemic may affect the industry in the coming year along with … trends. For the workers’ compensation and auto industries, challenges arose in the form of unemployment and decreased driving rates. For pharmacy programs, the beginning of the pandemic … Countless treatments have been studied (and are still being studied) to determine if there is an effective treatment for COVID-19. While studies and vaccines are still in progress, some drugs …
Podcast

Exploring the Psych Effects of COVID and Emergence of PTSD in Comp

…     None of us have gone untouched by the COVID-19 pandemic. This is especially true for frontline workers who care for the critically ill. So, in part three of our series on mental health’s impact on workers’ comp, we’re going to look at the psychosocial … without some small gain.” And, from my perspective, if there are positives that have come out of the COVID‑19 pandemic, I believe one is most certainly an increased awareness of mental health …
Blog

Celebrating Nurses Month

… to correspond with Florence Nightingale ’s birthday on May 12. For the first time ever, the American Nurses Association will expand National Nurses Week to a month-long celebration in May … a Difference”. While still practicing social distancing and health safety, Coventry and the American Nurses Association encourage everyone to think about creative ways to engage and … had emergency surgery. Immediately, Deborah reached out to my family and started the process of workers’ compensation. A few days after my surgery I finally spoke with Deborah and I have …
Article

Plugged-In: EV Collision Insights Q1 2024

… (EV) repairable claims frequency rose to 2.26% in the United States and 3.41% in Canada, an increase of approximately 40% and 38% respectively over Q1 2023. Tesla price reductions late last year … example, Cox Automotive reported that in the U.S. the “average transaction price at the end of 2023 for a new EV was $50,798, only $2,040 more than a gas-powered vehicle at $48,759”. That … In the U.S., EVs were written off as a total loss 9.93% of the time in Q1 2024 (up 8% from Q4 2023 and 30% from Q3 2023). Canadian EV total loss …
Article

What COVID-19 Is Teaching Us About Mental Health

… Pandemic anxiety, depression and isolation gives us a taste of what employees face in overcoming a work injury … understanding and appreciating mental health and its important role in maintaining activities of daily living. This is especially true now, as we struggle to cope with a pandemic that has … health and claims management. I was recently encouraged to see Risk and Insurance publish an article that focuses on the "7 Mental Health Myths — and Why They Matter in Workers’ Comp." …
Podcast

Calculating the Value of Evidence-Based PT

… true meaning behind it? Today, Enlyte’s Kim Radcliffe, DHA, MHA, PT, Senior Vice President of Product Management, helps us better understand what evidence-based physical therapy means and … responses and the evidence. It is also really making sure that we are applying the right types of treatment, the right quality treatment. Some of the basic treatments in physical therapy are, as I mentioned, exercise, which is a big piece, …
Article

Insurance Chatbots Are Transforming The Industry With Automation

… up everywhere. Just six months after their launch on Facebook Messenger, there were 34,000 of them on the platform. But just what are they and why do they matter? First, it’s important to understand that the term ‘bot’ encompasses many different types of technology, and the technologies themselves serve a huge range of purposes—from rules-based robotic processing automation (RPA) for automating back-office …
Author

Jean Costello

… the Network Solutions Integrated Networks Quality Improvement team. Jean has over 30 years of experience in the healthcare industry with specializing in quality programs, customer …
Article

2018 Recap and 2019 Predictions: P&C Regulatory and Legislative Changes

… to opioid prescribing limits. As the new year approaches, Mitchell takes a look back at 2018’s top trends and industry issues and projects what to watch for with 2019 predictions. … In 2018, there were a total of 314 CPT code changes, including ones to Surface Neurostimulator CPT code 64550, the new … deletions and revisions is available in the AMA CPT 2018 codebook under Appendix B. The American Medical Association 2019 CPT code set has a total of 335 code changes. The most notable …
Podcast

Work Comp Guidelines for COVID-19

… guidelines focus on specific issues that are most pertinent to their industry and the needs of injured employees. In today’s Inside Workers’ Comp, Leanne Bronold, clinical guidelines manager at Genex Services, informs us of her team’s development of such an important guidance tool. … : Well, as part of the Genex clinical guidelines team’s commitment to staying abreast of current medical trends, … sources. On Jan. 8, I received a health advisory for the first time from the CDC regarding an outbreak of pneumonia, at that time of unknown etiology, in Wuhan, China. So, by Jan. 17, the …
Article

StateWatch: Bill Review May/June 2019

… Department of Industrial Relations … Division of Workers’ Compensation … Bill Review (IBR) program. The “2018 Independent Bill Review (IBR) Report: Analysis of 2013-2017 Application Filings” summarizes the activity of an essential component of SB 863, providing an evaluation of the program during the first five … Ambulatory Surgical Center implants. Effective June 1, the surgeon should include the number of implants and type of implants at the end of the operative notes when submitting the claim in a …
Article

StateWatch: Bill Review May/June 2019

… Department of Industrial Relations … Division of Workers’ Compensation … Bill Review (IBR) program. The “2018 Independent Bill Review (IBR) Report: Analysis of 2013-2017 Application Filings” summarizes the activity of an essential component of SB 863, providing an evaluation of the program during the first five … Ambulatory Surgical Center implants. Effective June 1, the surgeon should include the number of implants and type of implants at the end of the operative notes when submitting the claim in a …
Blog

Texas Non-subscriber Case Management

… benefits to their employees. Texas law, however, gives employers the option to opt-out of workers’ compensation, thus becoming “non-subscribers”. This option has been available since 1913 in Texas. Approximately 22% of Texas businesses are operating as non-subscribers. One reason an employer may elect to opt-out is because the cost of workers’ compensation coverage can be …
Article

WorkCompWire: Case Managers Help Alleviate Covid-19’s Head-on Collision with the Opioid Epidemic

… As 2020 began, a persistent opioid overdose epidemic was near the forefront of a list of national concerns in the United States.  Some 20 million Americans  are reported to have a substance use disorder and two million of those misuse opioids. Continue reading here. …
Article

WorkCompWire: Case Managers Help Alleviate Covid-19’s Head-on Collision with the Opioid Epidemic

… As 2020 began, a persistent opioid overdose epidemic was near the forefront of a list of national concerns in the United States.  Some 20 million Americans  are reported to have a substance use disorder and two million of those misuse opioids. Continue reading here. …
Author

Anne Levins

… Anne Levins is the senior vice president of products and analytics for Network Solutions. She leads a team responsible for identifying new … the workers’ comp managed care industry, Anne has held various positions in customer service, account management, product development and information management. …
Blog

Specialty Medication Trends

… typically used to treat patients with complex, chronic conditions, continue to be a major area of pharmaceutical development and can have significant costs. Although they represent approximately 2% of drug utilization, they account for nearly 8% of prescription drug costs and represent the fastest-growing segment of the …
Article

Continuing Care During COVID-19

… knowledge to ensure injured employees are safely receiving the services they need in light of COVID restrictions. Moving Claims Forward: Continuing Care During COVID-19 When a local … utilized her long-term relationships with facility administrators to gain access and meet with an injured employee. The claimant was recovering from ENT surgery, but needed to be seen by the … progresses. For further questions on how Genex is moving your claims forward, contact your account manager. …
Article

How to Stop Paying for Billing Mistakes: Use an Auditing Technology Platform

… Medical billing mistakes are occurring at an alarming rate–external sources claim anywhere from 30 to 80 percent of medical bills could have some type of inaccuracy. Since many payors don’t have the most effective systems in place to identify … Many payors employ nurses to manually review a wide range of bills for mistakes that span from simple error types to issues that are too complex for even … amount of bills in one day. Relying on a small team of specialized medical experts to validate an endless volume of bills is not scalable, and often leaves payors to pay bills in full that …
News Release

Supporting Our Clients: An Update from Mitchell Casualty Solutions Technology Enabled Services

… and auto casualty clients. As the pandemic continues and we face new challenges ahead of us, we wanted to share what we've done to keep our services up and running during this time. … successfully maintained our ability to serve you with minimal disruption. Even before many of the stay-at-home orders were issued across the globe, we implemented our business continuity … business continuity planning and strong partnerships. Let's take a closer look at how each of these factors helped maintain our ability to serve you. Mitchell's Service Delivery Model …
Author

Lisa Robbins

… health care insurance and provider network industry. In her current role as senior director of network operations, she oversees provider data maintenance, provider credentialing and … and auto networks. She has been with Coventry for 27 years and has extensive knowledge of Provider Networks including Network Operations, Sales Support, Account Management, Product Management, and Claims and Customer Service Operations. She holds a …
Author

Dora Morris

… Dora has over 24 years of leadership experience working in the health care and workers’ compensation industry. Her responsibilities include providing leadership and strategic direction to sales and account management. These teams partner with and support insurers and third-party administrators in the development of program initiatives that deliver prompt and accurate services. Her expertise and record of …
Article

The Opioid Epidemic: Using Opioid UDS to Empower Better Outcomes

… to the Centers for Disease Control and Prevention (CDC), in 2014, more than 28,000 people died of opioid overdoses, 129 people every day as a result of drug poisoning, and 61 percent are … expected to decrease reimbursement. 4 According to CMS, the agency does not recognize the 2015 American Medical Association current procedural terminology code changes for UDS because of “our … class method (e.g. Immunoassay, enzyme assay) each drug class” and excludes chromatography. 6 An example of reimbursement by CMS for CPT code G0431 at POC is $160. This may vary for state fee …
Article

Plugged-In: EV Collision Insights Q2 2024

… (BEVs) rose to 2.5% in the U.S. and 3.94% in Canada in Q2 2024—a year-over-year increase of 45% and 39% respectively. According to the Alliance for Automotive Innovation , EVs represented 9.3% of new U.S. light-duty vehicle sales in Q1 2024, down from 10.2% in Q4 2023. Similarly, in Canada … up 2% and 27% respectively over Q2 2023. Mild hybrid electric vehicles (MHEVs), which combine an internal combustion engine (ICE) with a small electric battery, saw claims frequency of 3.8% …
CE Webinar

Drug Trends Analysis: Evaluating an ever changing pharmacy landscape in workers’ compensation

… drug classes and dispensing channels, and numerous regulatory changes all require new levels of analysis and understanding. This webinar provides insightful perspectives on the trends behind …
Conference

Enlyte Envision 2026

… 2026 brings together the brightest minds in auto and workers’ comp claims management for an exclusive, invitation-only experience where innovation, strategic insights and meaningful connections converge in the stunning coastal setting of Carlsbad, California. Why Industry Leaders Make Enlyte Envision a Priority … —Meet with regulatory, technology and clinical experts who provide first-hand demonstrations of AI-powered solutions, advanced analytics and integrated services that deliver measurable …
News Release

Workers compensation.com: WC Experts Opine on Latest Guidance on ADA and COVID-19 Long Haulers

… COVID-19 may be covered under the Americans with Disabilities Act. On the 31 st  anniversary of the signing of the landmark legislation, President Biden announced that some so-called "long haulers" can be protected under the ADA – if the condition or any of its symptoms is a physical or mental impairment that substantially limits one or more major …
Article

Total Loss Trends Emerge Amidst the Pandemic

… Every industry has been impacted by actions taken to control the spread of COVID-19, including the automotive industry. Growing unemployment, coupled with a pivot to … Flattening of a Different Curve … in their sales practices to accommodate a shift to online vehicle purchases as a result of social distancing. While J.D. Power recently reported up to a 15% reduction in wholesale prices in certain regions of North America, given the sales environment it is unlikely retail price reductions will follow …