Podcast

Managing the Labor Challenge: Provider Networks

… employees back to work and back to their routines as quickly as possible. And when you have an injury, medical treatment is one of the more important things, as well as getting the injured … providers have signed a contract. The adjusters know who they're contracted with, so they have an understanding of how that particular network or that particular payer works. The network vets … so, they become comfortable with those protocols as they keep doing it over and over again. An example, say an adjuster uses a certain primary provider who, in turn, uses a certain …
News Release

Enlyte Announces Its 2024 Heart of Case Management Award Winners

… humming along,” said Helen Froehlich, Senior Vice President, Utilization Management. “It’s not an easy task, considering the severity of injury or illness may not only be mobility limiting, … burn injuries return to the cockpit. Another used her critical thinking skills to accommodate an employee with a chronic mental disorder, allowing him to resume employment at his “dream job.” Two others ensured an employee who accidentally amputated her fingers and a non-compliant injured employee received …
Podcast

Empowering Injured Workers

… I think that for an injured worker they have a few simple, but very important issues and questions that would make … bringing in a nurse case manager or really some sort of advocate, because I really see this as an advocacy based model. Having that front‑line contact to assist in understanding the process … you need to be able to make decisions about your health, about your injury. Ideally, an injured worker would fully understand the claims process, they would feel like they are being …
Podcast

Case Severity: What Factors are You Missing in Delayed RTW Cases?

… multimedia series in which subject matter experts discuss problems and offer solutions to top issues affecting our industry. I’m Tom Kerr and today we’re speaking with Mariellen Blue … Whenever an individual sustains a work-related injury or illness, the length of treatment and the … OK so let’s say an injured worker sustains a sprained knee he’s going to have a lower case severity score, right? … at that compensable diagnosis because that really doesn't tell the whole story. I'll give you an example with comorbidity calculator. Let's say we have an individual, 30-year-old male, and …
Article

Specialty Solutions Spotlight: Home Modifications in Workers’ Compensation

… size of bathrooms, and how well the injured employee might be able to move from room to room. An Apricus home modification coordinator can facilitate communication across all parties … the case manager, builder/contractor and the injured employee. They can also work with an occupational therapist who can play a critical role in helping identify the injured employee’s … owns the home, it may be necessary to determine whether there are any regulations from an entity such as a homeowners’ association. A copy of the deed might also be required. …
Case Study

Heart of Case Management Awards 2018

… Out-of-the-box thinking is sometimes necessary for ensuring the best care and recovery for an injured employee. For Martin, those critical thinking skills were put to the test in a case … would benefit from having his family nearby, Martin quickly coordinated his transfer to an acute rehab facility that would accept an out-of-state jurisdiction claim and the associated rates of reimbursement. When it came time …
Article

Are You Paying for Mistakes? The Impact of Errors in Workers' Comp Medical Billing

… The chart below provides an overview of how frequently each of these types of errors occurred in our analysis. … different bills. A split bill, like most billing issues, may fall into one of two categories: an error or an abuse. Split billing is considered an error when coders do not understand the appropriate … automated auditing platform to help improve medical review efficiency and cost containment. An auditing technology platform can quickly sort through bills, make edits where appropriate and …
Article

Building a Strong Company Culture For Better Outcomes, Brand Beliefs, and Behaviors.

… An Inside Out Approach … Mitchell has taken an inside out approach to culture, with the expectation that it will have a direct, positive … what customer touch points look and feel like. For companies with strong, positive cultures, an inside out approach can be an essential tool for strengthening customer relationships. … have a number of ways we reinforce culture, and communication plays a key role. First, we have an active internal social media channel where employees all across the company publically …
Article

Plugged-In: EV Collision Insights Q2 2023

… repairable claims frequency rose to 1.49% in the US and 2.64% in Canada in Q2 2023, which is an increase of 0.36% and 0.23% respectively over Q1. Tesla, the largest EV manufacturer in the … share actually increased to 70.67%, up from 67.87% in Q1, with the Model S reappearing in the top 5 list of most frequently repaired EVs in the country. EV Frequency of Repairable Claims … in the US by 2030. EV Q2 2023 Statistics EV Average Repairable Severity Q2 2023 By the Numbers Top North America EV Markets Based on Repairable Claims Frequency Q2 2023 Top EV Model Frequency …
Article

Ask The Pharmacist: Brand Name Versus Generic Medications in Workers’ Compensation

… Research” phase where animal testing is applied. The drug manufacturer can then apply for an “Investigational New Drug” (IND) application. If approved, the IND would allow the drug … may begin making their versions of the brand name drug.  The generic manufacturer submits an “Abbreviated New Drug Application” (ANDA), which in essence allows them to request approval of … may cause a small fluctuation in blood concentration and result in lower effectiveness and an increase in clotting. Another possible scenario where a brand might be substituted for a …
Article

Average Length of Rental for Repairable Vehicles: Q2 2018

… Average Length of Rental (LOR) for Q2 2018 landed at 11.6 days in the United States, an increase of 0.1 days compared to Q2 2017. This stagnation in the 2nd Quarter is now an official trend after similar results in 2017 and 2016. Once again, there was very little … days for Q2 2018. This result fell exactly in the middle of the two comparison periods. It was an entire day shorter than the 90-day period immediately preceding it (Q1 2018) where LOR was …
Blog

It's time to rethink how we talk about Specialty Networks

… as miscellaneous and extra, a secondary need. But for workers struggling to recover from an injury, these services are more properly thought of as essential, not just nice-to-haves. … health, among others, are often foundational to workers’ recoveries. These offerings are such an added benefit for managing a workers’ comp claim in a way that’s best for workers and for … experience when they receive the appropriate specialty services. Specialty Networks add up to an all-inclusive experience for the injured worker. That’s why the birth of Apricus is so …
News Release

FDA Authorizes Second Coronavirus (SARS-CoV2) Vaccine for Use

… that they'll each deliver 100 million doses in the first quarter. Moderna has contracted for an additional 100 million doses to deliver in Quarter 2, negotiations with Pfizer are continuing … care residents and facility staff are now underway, in keeping with the recommendations of an independent expert panel advising the Centers for Disease Control and Prevention (CDC) . FDA … open and transparent scientific review process, two COVID-19 vaccines have been authorized in an expedited timeframe while adhering to the rigorous standards for safety, effectiveness, and …
News Release

Minnesota, Montana and Wyoming Pass Opioid Prescribing Limit Laws

… rules for how anticipated settlement money from their opioid lawsuit will be managed. Creates an opiate product registration and reporting requirement for drug manufacturers and distributors, requiring them to report the delivery of all opiates into the state. In an effort to continue to address the opioid problem in Minnesota, the legislation also … opioid naive patients. Opioid naive patients are defined as individuals who have not received an opioid in the 90 days prior to the acute event. The prescribing limits are effective on …
Article

The Top 6 Uses for Diagnostic Imaging in Workers’ Comp

… treatment plans, imaging is integral to facilitating informed decision making and optimizing an effective return-to-work process. In workers’ compensation diagnostic imaging is used to: … Determine whether an injury is work related … » Empowers decision makers to make informed decisions about when an injured employee is qualified to work, evaluate if and when they can go back to work or determine if modified duty is an option. Diagnostic imaging plays a pivotal role in the process, acting as a catalyst for …
Blog

Will Naloxone Become Available for Purchase without a Prescription?

… are only obtainable with a prescription. The Food and Drug Administration ( FDA ) believes an over the counter (OTC) version may remove barriers for obtaining naloxone, particularly for … of a consumer-friendly Drug Facts Label (DFL). Any new drug application or supplement for an OTC drug product, along with required studies demonstrating consumer understanding, must be … has taken some unprecedented steps to encourage drug companies to enter the OTC market with an over-arching goal of increasing access to naloxone. For the first time in its history, the FDA …
Case Study

A Brighter Day

… employees who she supports during the disability period of their care management. Below is an example of how Ms. Carilli makes a difference by serving as an advocate for injured workers.   … condition and spent most of the day crying. Her primary care provider (PCP) had prescribed an anti-depressant and suggested she find a support group for breast cancer survivors. During the … education and support. Challenges continued, however. When the employee tried to arrange an appointment with a recommended provider, she found there were no available appointments for …
Article

The Future of Paintless Dent Repair

… chemicals, fillers, paint and replacement parts. This allows trained technicians to deliver an environmentally friendly and minimally invasive repair. And, in many cases, that repair can be … the repair operation. As vehicles become more complex and their repair more costly, there is an even greater opportunity to expand the use of PDR as well as equip PDR technicians with the latest technology, training and professional standards. In this white paper, we provide an update on the current state of PDR, explain how the right learning model can develop the …
News Release

Evzio Naloxone Auto-Injectors Discontinued

… marketing statuses. The FDA approved Evzio auto-injector to temporarily reverse the effects of an opioid overdose . The drug is designed to be administered outside of the healthcare setting by … Alternative naloxone products such as Narcan nasal spray continue to be available for use in an overdose situation. In the workers' compensation or auto casualty industry, patients may have been prescribed the naloxone auto-injector along with an opioid prescription. The reason for discontinuation of the auto-injectors is unknown; however, …
CE Webinar

Nurse Triage: Establishing Trust at the Time of Injury

… This session examines the support nurse triage can provide to an injured worker and the role employers and carriers play in building trust at a vulnerable time when an injured worker can easily veer off course. …
Article

Outdated imaging equipment can affect quality of care and cost of claims

… Among specialty services, diagnostic imaging—such as an MRI, CT, or PET scan—is often the first critical step to assess the severity of an injury and develop a treatment plan for prompt recovery and return to work. That's why it's imperative an imaging facility produces a quality image from the onset to ensure best-possible outcomes for …
Blog

How to Find the Best Providers

… medical spend, we'll look for that in the data and those are the providers that we'll consider top tier. … are on the claim that there are better results — less time off, less medical spend — that is an indicator that the provider is working with our case managers and showing the value of both … necessarily mean that there's going to be more spend or longer time out of work but it is an indicator that he's not following the guidelines. So, that's a negative indicator. We also …
Article

Could Virtual Reality Be the Next Treatment for Chronic Pain?

… .  The EaseVRx program consists of 56 VR sessions that are 2-16 minutes long as part of an eight-week treatment program. The FDA authorized EaseVRx based on an eight-week study of 179 people with chronic, low back pain that had lasted six months or … review and being cleared or approved by the FDA. The EaseVRx system could possibly be used as an alternative to medications, such as opioids, for chronic back pain. Research has shown that …
Article

Could Virtual Reality Be the Next Treatment for Chronic Pain?

… .  The EaseVRx program consists of 56 VR sessions that are 2-16 minutes long as part of an eight-week treatment program. The FDA authorized EaseVRx based on an eight-week study of 179 people with chronic, low back pain that had lasted six months or … review and being cleared or approved by the FDA. The EaseVRx system could possibly be used as an alternative to medications, such as opioids, for chronic back pain. Research has shown that …
Article

Field Case Management-A Matter of Life and Death

… Telemedicine is starting to be considered by some as an ideal treatment modality for coronavirus social distancing. However, what happens when true … received a call from the physician’s office that the appointment was being changed from an in-person to telemedicine visit due to COVID-19 precautions.    Since the officer had recently … decrease in cardiac output and mentioned both issues to the physician during the appointment. An EKG was performed, and the results showed the officer was still experiencing atrial …
Article

Making Recall Data Available When it’s Most Valuable: At the Time of a Vehicle Repair

… to recall vehicles and equipment that have safety-related defects. Anyone can report an issue with any vehicle to the NHTSA. The process is as simple as reporting the complaint for … on the NHTSA website. When the NHTSA receives a number of similar complaints they launch an investigation to determine if there is in fact a safety risk to consumers, and if so, does the … available, unless the recall has generated media coverage, most consumers won’t have it top of mind to check safety recalls on their vehicle. "One method to inform consumers is to push …
Article

Will We See Human Interaction Disappear with AI in Insurance?

… Today, consumers own an average of 3.64 connected devices each, and it’s a given that they expect a seamless digital … in. Fortunately, AI provides a couple of new ways for consumers to connect that do not require an app—chatbots and voice-first interfaces. While we’re more connected than ever, app saturation … in. Fortunately, AI provides a couple of new ways for consumers to connect that do not require an app—chatbots and voice-first interfaces. First, let’s take a look at chatbots. Like their name …
Article

Technology Integrations Are Transforming How Pharmacy Benefits Managers Monitor Drug Therapies

… The Claim Journey—an Opportunity for Impact … In workers’ compensation, we often talk about the journey of a claim, but when an employee is injured on the job, it is the beginning of a journey for them, too. Each decision point in the claim lifecycle is an opportunity for the payor to positively impact an injured party’s journey and get them to … treatment paths are taken, and intervene with the prescriber to keep drug therapy on an appropriate path. Technology is bringing many changes to workers’ compensation insurers, and …