Article

CPT Code Changes for 2018: Things to Look Out For

… reimbursement. Though CMS is expected to release pricing for diagnostic tests as they usually do, the degree to which insurers will allow reimbursement for these rapidly issued codes remains …
Conference

National Workers' Comp Conference 2017

… currently facing, their perception of the workers’ compensation industry and what they would do if they had a magic wand. Those thoughts and musings ultimately turned into a visual …
Article

Reflecting on 2017: Predictions for 2018 in Workers’ Compensation

… using medical marijuana to treat a workplace injury. However, other states such as Florida do not allow for reimbursement and many others have not addressed the issue at all. Clearly, … employers to encourage the use of a network provider by an injured worker, but the states do not require this. With unemployment rates moving downward, employers have a harder time …
Article

Elevating Work Comp Care Through Physical Medicine Innovation

… Physical Medicine Strategy  A workers’ compensation physical medicine program must do more than simply offer physical therapy— Apricus offers a program that not only elevates …
Article

Seven Technology Features to Look for in a Medical Management Software Solution

… skilled medical professionals on a tight timetable. In order to accomplish these goals, many top-performing organizations are turning to technology. As utilization review becomes more … review manager or supervisor needs the right software to work as efficiently as possible. To do your best work, be diligent in choosing the best software available for your specific needs. …
News Release

Kentucky Administrative Rule Updates

… requests. The Genex UR/MBA plan is currently approved through 9/27/24. Per the state, we do not have to recertify our plan until our plan is ready for renewal. However, as we must adhere …
Article

Liability and Injury Evaluations: Understanding the Two Types of Recommendation Models

… bodily injury teams use a number of different approaches and tools to settle claims, but they do share a similar set of goals—settling claims efficiently and accurately. With so many factors …
Article

The Black Lives Matter Movement Is Changing Us for the Better

… on the side of the road and wait for the storm to pass. As evidenced by USA Today’s report on top stocks thriving during the pandemic , the companies who continue taking risks and investing … like Lowe’s and Walmart change operating models at an extreme pace, while many of the nation’s top auto insurers took advantage of changes in driving habits and returned premiums to maintain …
Blog

Impact of Masks on the Deaf Community

… repeating yourself. Trying a different word, phrase, or method of communication. Whatever you do, resist the urge to give up. Your effort can make a big difference to a Deaf person, and …
Virtual Event

Webcast: Workers’ Compensation Legislation Addressing Essential Workers Affected by COVID-19

… be caused by their line of work and therefore should be compensable. Typically, presumptions do not include illnesses such as the common cold or flu, since it is extremely difficult to prove …
Article

Changing Consumer Expectations: Lessons from Home Delivery Services

… questions: Are your patients looking for more flexible options to receive their prescriptions? Do you have any rural patients looking for easier ways to receive their prescriptions? Are any …
Article

The Power of User Experience: How to Simplify the Claims Decision-Making Process

… three and 15 different software programs every day. Each of these systems helps adjusters do their jobs effectively, but switching between systems and trying to gather information from …
News Release

New York Adopts Final Drug Formulary Rule

… Carriers have four days to respond to a request for prior authorization. If they do not respond, the request is deemed approved. Communication regarding prior authorization …
Article

Vehicle Scanning for a Computer Network on Wheels

… a chart listing items needing recalibration after repair. Per Honda, “The chart at the top of the next column shows damage areas where driver assistive system components may be located … impacts cycle time. Overextended dealers are not typically focused on sublet scans as a top priority. Also, it’s expensive both in labor and sublet costs. Collision shops have even been … Where Do We Go From Here? …
Article

Using an Advanced Medical Bill Review Platform to Improve Third Party Outcomes

… many different billing codes they come across on any given day. In addition, many attorneys do not understand detailed compliance rules, which means it is essential for adjusters to have …
Article

Ask The Pharmacist: Asthma and Smoke Inhalation Treatments

… with a health care professional such as the prescribing doctor or dispensing pharmacist. Do you have a workers’ compensation or auto-related pharmacy question? Send us an email at …
Article

Decoding Functional Restoration Programs: Ensuring Accurate Billing Practices

… under 97799 include unique or emerging therapies like dry needling or hippotherapy, which do not have specific CPT codes. The main takeaway is 97799 should only be used as a last resort …
Article

Safeguarding Medicare's Interests: Strategies and Updates
Article

A virtual silver lining: the pandemic’s boost to telemedicine

… of motion, and skin irritation. They can ask questions and relay treatment options. Patients do not have to be physically present for that initial examination or for follow-up discussions …
Blog

Destination Care

… bundled cost structures. Centers of excellence concentrate on key medical procedures - and do a whole heck of a lot of them. In addition to focused clinical teams, “patient navigators” act …
Blog

Beyond the Status Quo

… led to an industry mindset that to be the “best” with provider directories, you just had to do “more and more often.” But you could never scale up enough to fully impact accuracy. You …
Article

Global Surgical Package Fraudulent Billing

… of the surgeon during the post-operative period of the surgery because of complications, which do not require additional trips to the operating room Follow-up visits during the post-operative …
Article

Average Length of Rental for Repairable Vehicles: Q4 2023

… overall LOR was often the highest in the nation. While Louisiana’s LOR is still in the top 10 overall, the state recorded a drop of 2.7 days, which is the largest decline in LOR in the … offered: “Shops also may be processing more work more quickly as they gain the ability to do more ADAS calibration and related work in ways other than subletting it to new-car dealers, … total losses, LOR was 23.6 days, a 1.8-day decline from Q4 2022. A large gap exists between top and bottom; PEI recorded the highest LOR at 32.5 days, a 2.7-day increase, while Newfoundland …
Podcast

How PTSD is Affecting Return to Work

… How do case managers help target those at risk of PTSD? …
Article

California Senate Bill 1160: New Utilization Review Regulations Take Effect January 1, 2018

… clinic is staying within the treatment guidelines for Mike’s lumbar strain. All he can do now is make the occupational clinic get preauthorization for any further treatment on Mike’s …
Article

StateWatch Summer 2016

… on the treatment of carpal tunnel syndrome do not recommend the routine use of magnetic resonance imaging, or MRI, for diagnosis. In … – Diclofenac gel + Cleansing wipes ($500) While packs and kits do not reflect a large percentage of transactions, they are among a group multiple cost drivers …
Article

When Good Intentions Misfire in Workers’ Comp Pharmacy

… Most jurisdictions do not allow workers’ compensation payers to demand use of pharmacy networks, often termed …
Article

Migraine Medication Trends in Work Comp

… dive into our annual drug trends report. I'm Tom Kerr, and today we'll be highlighting a top trend from the data we observed within all calendar year retail and mail order transactions … and cost per claim were down across all the therapeutic categories in 2024, in that top ten that we normally carve out ranked by cost. … And to particular, what we saw in the trends were two therapeutic categories that fall in that top ten therapeutic category ranking by cost that rose by roughly 10%. …