Article

StateWatch Fall 2015

… International Association of Industrial Accident Boards and Commissions (IAIABC) is developing an informational packet on how formularies work for lawmakers and regulators, WorkCompCentral … website to access the report. Also, the state’s Division of Workers’ Compensation (DWC) posted an order June 17 adjusting the Durable Medical Equipment, Prosthetics, Orthotics and Supplies … Case law update: In Coats v. Dish Network , the Colorado Supreme Court recently ruled that an employer lawfully terminated a quadriplegic employee for his off-the-job medical marijuana …
Article

5 COVID-19 Security Threats to Know About

… has helped social distancing efforts across the country, it has also opened up companies to an onslaught of new security threats. … cyberattacks peak this year on April 7, 2020 with a total of 1,417,827 attacks, according to an Atlas VPN report. This was a 330% increase during the period March 10–April 10, 2020, compared … or about 7%, are classified as “risky” or “malicious”—heightening cyber risk. There has been an increase in email scams that impersonate organizations like the Center for Disease Control …
Article

Health Literacy’s Impact on Delayed Recovery

… Management, Genex Services. Workers’ compensation professionals are seeing delayed recovery as an increased challenge in claims—as injured employees may not be progressing along a medically … that over a third of adults have a basic or below-basic understanding of health information . An injured employee may be directed by their treating physician to take a medication a certain … of miscommunications and misunderstandings—can lead to poor claims outcomes. The condition of an injured employee may worsen. The injured employee may not recover in a timely fashion or …
Article

From RPA to Cobots: Automation in Insurance and Collision Repair

… impact of automation on the Property and Casualty and collision repair industries has become an increasingly hot topic—presenting challenges and opportunities for claims and insurance … minutes to do, and that person typically does that task 30 times a day, he or she would have an hour each day to put to better use. Companies will experience savings of between $5 trillion … process automation and add intelligence to it. In May, Google announced Google Duplex , an extension of Google Assistant that can make phone calls, appointments and reservations for …
Article

The Power of Integration and Automation: Humanizing the Claims Process

… Getting injured on the job or in an auto accident can have a significant impact on a person’s life. Going through the process of … & Casualty (P&C) claim, with delays adding to their burden. One of our collective goals as an industry is to simplify the claims process as much as possible to create better experiences and outcomes for anyone injured in an unfortunate event, whether it takes place at work or on the road. But with regulatory …
News Release

Oklahoma Joins Growing Chorus of States Limiting Opioids

… the Controlled Substances Act, defining it as “pain that persists beyond the usual course of an acute disease or healing of an injury.” Chronic pain “may or may not be associated with an acute or chronic pathologic process that causes continuous or intermittent pain over months or …
Article

Making the Most Out of Your Data: Four Tips for Engaging with Claims Consultants

… advancements in repairing today’s complex vehicles while still leveraging data to manage an efficient and profitable claims operation. Engaging with an expert consulting partner that combines data and analytics with deep industry experience can … one of the clearest paths to achieving actionable insights that have the ability to transform an organization. "We have identified four best practices that provide the best chance for success …
Article

Strengthening Return-to-Work Outcomes: A Guide to Vocational Case Management for Claims Professionals

… When a workplace injury disrupts an employee’s ability to work, the path back to productivity can be complex. Vocational case … Vocational referrals are commonly triggered when: An employee cannot return to their pre-injury employer. Physical restrictions prevent full-duty … by state or federal regulations. For example: Nevada mandates vocational rehabilitation when an injured or ill employee has permanent restrictions that prevent returning to the pre-injury …
Article

Five Things You May Not Know About Your Case Manager

… They’re available to answer questions about the injury and break down all options for healing. An empowered and respected injured worker is also unlikely to seek legal action . In fact, one … Knowing the ins and outs of an injured employee’s job is critical to helping him or her return to work safely. This knowledge impacts everything from following an appropriate treatment protocol to developing light-duty options. That’s why most case managers …
Article

How Naloxone Can Help Fight the Opioid Crisis

… the impact of the opioid crisis. According to the CDC , almost 400,000 people died from an opioid overdose between 1999 and 2017. On average , more than 130 Americans die from an overdose every day, both from prescription (e.g., oxycodone, fentanyl, morphine, hydrocodone) and illicit (heroin, synthetic fentanyl) opioids. An opioid overdose leads to breathing difficulties, whereby breathing becomes shallow or even …
Article

Medicare proposed rulemaking and enhancements to the MSP Recovery Portal

… is to ensure that beneficiaries are making the best health care choices possible by providing an opportunity to select an option for meeting future medical obligations that fit their individual circumstances while … only to later pull them back.  In June 2016, CMS announced that they were considering an expansion of the MSA review process to include Liability and No Fault MSA’s.  Additionally, … scheduled to be released in September 2019 This past Tuesday CMS hosted a webinar to present an overview of the upcoming self-reporting functionality that will be added to the Medicare …
Article

Medicare proposed rulemaking and enhancements to the MSP Recovery Portal

… is to ensure that beneficiaries are making the best health care choices possible by providing an opportunity to select an option for meeting future medical obligations that fit their individual circumstances while … only to later pull them back.  In June 2016, CMS announced that they were considering an expansion of the MSA review process to include Liability and No Fault MSA’s.  Additionally, … scheduled to be released in September 2019 This past Tuesday CMS hosted a webinar to present an overview of the upcoming self-reporting functionality that will be added to the Medicare …
Author

Donita Stacker

… for delivering exceptional customer experiences during various implementation stages. As an operational leader, Donita collaborates with technical and operational teams to establish conversion strategies, capacity planning and outcome monitoring to ensure an overall successful program. …
CE Webinar

Nurse Triage: The Time is Now

… credible information: a nurse. This session examines the support nurse triage can provide to an injured worker and the role employers play in building trust at a vulnerable time when an injured worker can easily veer off course. This webinar was sponsored by IWCP.  …
Article

Public Risk: Quality-Assure Your IMEs for the Benefit of Your Workers' Compensation Program

… An Independent Medical Examination (IME) is a valuable tool in the workers’ compensation claims … should be aware of the various situations in which their claims staff might benefit from an IME being ordered, as it can help them make decisions on complex cases. For example, claims …
Article

Public Risk: Quality-Assure Your IMEs for the Benefit of Your Workers' Compensation Program

… An Independent Medical Examination (IME) is a valuable tool in the workers' compensation claims … should be aware of the various situations in which their claims staff might benefit from an IME being ordered, as it can help them make decisions on complex cases. For example, claims …
Podcast

ePay: A Simple Solution to Improve Claims Efficiency

… : Most workers’ compensation executives would consider improving claims efficiency a top priority, yet one of the easiest ways to help meet this goal, electronic payment processing remains an untapped resource. While most of us have replaced traditional checkbooks with online banking, … up to speed with electronic provider payments. So, Sanjog. Let’s start with this. What are the top trends you’re seeing today regarding digital payments and how have things shifted since the …
Article

How to Better Review Costly Hospital, Emergency Room and Other Medical Bills for Third Party Claims

… the Medicare fee schedule as the pricing benchmark in their bill review system and customize an optional percentage multiplier of Medicare that they would like adjusters to use across the … fee schedule as the pricing benchmark for third party bills helps to provide adjusters with an easy, consistent and understandable way to apply pricing. … In order to settle a third party claim, carriers typically have to negotiate with an attorney or claimant. In the negotiation process, it can be challenging for adjusters to …
Article

Average Length of Rental for Repairable Vehicles: Q1 2019

… Average Length of Rental (LOR) for Q1 2019 landed at 12.8 days in the United States, an increase of 0.3 days compared to Q1 2018 . Once again, there was very little consistency … last year ( Q1 2018 ), where LOR for each quarter was 12.7 days. The United States witnessed an LOR increase of 0.3 days (to 12.8) for Q1 2019 vs. Q1 2018, which meant that for Q1 2019, … Because of its relative proximity to major Canadian population centres, the Northeast U.S. is an interesting data comparison point. It’s LOR landed at 13.7 days for Q1 2019. Consistent with …
Article

WorkCompWire: How Outdated Imaging Equipment is Impacting Quality of Care and Claim Costs

… In workers’ compensation, diagnostic imaging – such as an MRI, CT, or PET scan – is often the first critical step to assess the severity of an injury and to develop a treatment plan for prompt recovery and return to work. It’s imperative …
Article

StateWatch: Fall 2018

… has approved a non-opioid, percutaneous electrical nerve field stimulator device as an aid to reduce opioid withdrawal symptoms during detoxification. The device sends electrical … System (IRIS) to analyze claims in which at least one prescription was dispensed to an individual in 2016 or 2017. WATCHLIST: … is awaiting approval by Gov. Brown. It would require the administrative director to establish an antifraud support unit within the Division of Workers’ Compensation. The bill would set forth …
Article

StateWatch: Fall 2018

… has approved a non-opioid, percutaneous electrical nerve field stimulator device as an aid to reduce opioid withdrawal symptoms during detoxification. The device sends electrical … System (IRIS) to analyze claims in which at least one prescription was dispensed to an individual in 2016 or 2017. WATCHLIST: … is awaiting approval by Gov. Brown. It would require the administrative director to establish an antifraud support unit within the Division of Workers’ Compensation. The bill would set forth …
Podcast

Safe at Home: Managing the Provider Shortage in Home Health

… : An important issue that’s impacting all areas of health care is the provider shortage. Having … : Tom, thank you for having me. It’s an important topic, and I’m excited to talk about what’s impacting our markets.  … delays, all that uncertainty can bring forth additional hospital stays, prolonged services, or an escalation in the type of service that is required, which can lead to additional or heightened …
Article

Secrets to a Successful Stay At Work Program

… A stay at work program is when employers have a program in which they will accommodate an employee’s needs based on restrictions and limits where an accommodation is needed in order to stay at work and be productive in the workplace. So, for instance, if an employee has a back injury and the job requires that the person can lift 20 pounds, and he or … to it is just understanding what the program requirements would be. That there needs to be an interactive process, there needs to be a discussion so the two sides can talk about what is …
Article

Secrets to a Successful Stay At Work Program

… A stay at work program is when employers have a program in which they will accommodate an employee’s needs based on restrictions and limits where an accommodation is needed in order to stay at work and be productive in the workplace. So, for instance, if an employee has a back injury and the job requires that the person can lift 20 pounds, and he or … to it is just understanding what the program requirements would be. That there needs to be an interactive process, there needs to be a discussion so the two sides can talk about what is …
Podcast

What to Look for When Choosing a Provider Network

… network that consists of any and all provider specialties that may treat a workplace or an auto accident. But I also think partnering with an organization that puts an emphasis on supporting providers is just as important. Doctors and nurses or psychologists or … well as feedback mechanisms from clients, and even patients. You’re also going to want to find an organization that puts an emphasis on learning through advanced data analytics. So, we’ve seen …
Article

Consumer Self-Service Expectations are the New Normal

… customer is already part of a global community in which access to virtually anything, through an internet-connected piece of glass, is commonplace. Easy, self-serve, any-time interaction is … they can get back to what they were doing before the issue arose.” This explains why an intuitive, mobile First Notice of Loss solution (FNOL) can go a long way toward securing … are increasingly expecting—a few clicks or swipes of a mobile device to file a claim, obtain an estimate, have the repair started, and “get back to what they were doing before the issue …
Article

Specialty Solutions Spotlight: How Bone Growth Stimulators Accelerate Healing

… Who is best suited to use a bone growth stimulator after an injury? Recovering from a broken bone can be a long and difficult journey, often accompanied … of BGS depends on factors like the severity of the fracture, the specific bone affected, and an individual’s health risks. Severe injuries, such as those from auto accidents, or complex … medical conditions or medications can significantly slow the recovery process, making BGS an invaluable tool. Injured employees taking insulin, anticoagulants, anticonvulsants or high …