News Release

Enlyte’s 2024 Trends Report Addresses Top Challenges in the P&C Industry

… subject matter experts at Enlyte, the parent company of Mitchell, Genex and Coventry. In an extensive report covering a wide array of today’s most pressing issues, industry leaders … an increasing aging population and decreasing provider pool has created a health care shortage … claims frequency and severity were on the rise in 2023. Combined with an already stressed parts supply chain and an unprecedented autoworkers’ strike, it created a …
Article

P&C Industry Claims Severity: Trends, Drivers and Mitigators

… Claim severity has always been top of mind for the P&C industry. While the pandemic has certainly had an impact on claims costs, there are several drivers behind claim severity trends varying by … affect a claim’s development,” Mariellen Blue and Jim Harris (Genex Services) explain in an article for Workers’ Compensation magazine on claim severity scoring. Preventative services, … blame—driving higher parts prices as a result of government spending, supply chain imbalances, an increase in the cost of raw materials and other factors,” explains Ryan Mandell (Director, …
Article

Average Length of Rental for Repairable Vehicles: Q2 2019

… Average Length of Rental (LOR) for Q2 2019 landed at 11.8 days in the United States, an increase of 0.2 days compared to Q2 2018 . Once again, there was very little consistency … Because of its relative proximity to major Canadian population centres, the Northeast U.S. is an interesting data comparison. Its LOR landed at 12.6 days for Q2 2019. Consistent with past … Alberta and PEI both produced LOR decreases over Q2 2018. Meanwhile, five provinces posted an increase over last year, although three of those five provinces (Ontario, Newfoundland and …
Article

Five Guidelines for Provider Data Management

… of issues for claims organizations, notably workflow inefficiencies and suboptimal outcomes. An accurate provider database can help to improve efficiencies, but managing provider information … source of truth. From a myriad of perspectives, chief among them being compliance, this is an important acceptance criteria for the program. … the span of data elements but that actually represent the same provider. In order to have an accurate and “clean” provider database, it’s important to resolve both types of duplicate data …
Article

Back to the Basics: Cost Control and the Role of Precertification and Utilization Review in Workers’ Compensation

… averaging well over 60 percent of average claims costs, 1 represent a significant impact on an employer’s workers’ compensation total cost of risk. This trend isn’t going away soon, as this … years. Contributing to the climb are expenses incurred for treatment that are unrelated to an injured workers’ injury. While unnecessary medical treatment could occur for a number of … to treat their condition. Utilization review, starting with the precertifcation, presents an effective method in the defense against rising medical costs. …
Author

Keith Higdon

… full P&L responsibility for one of the largest third-party claims administrators. Higdon is an active industry and academic contributor, having served as an advisor, mentor, and adjunct faculty member. He holds a Master of Information Technology and …
News Release

Mitchell Pharmacy Solutions Responds to COVID-19 National Emergency

… The country is facing an unprecedented emergency related to the COVID-19 virus and it is disrupting many facets of our daily lives. Most states have declared an emergency and the CDC and the White House have issued strong recommendations to limit public …
Article

A Deeper Look at Utilizing Generic Drugs in Workers’ Comp

… with satisfactory results from preclinical research, the first step taken is typically to file an Investigational New Drug (IND) application with the Food and Drug Administration (FDA) to set … can extend their market exclusivity. With brand medications in mind, we’re keeping an eye on the migraine therapeutic class at present. There is a new category of migraine … report these brand only migraine medications are driving this treatment category into the top ten therapeutic classes by spend for the first time. These drugs have an average wholesale …
Article

Channeling Your Inner Resilience to Foster Return to Work and Productivity

… as resilience, the ability to adapt to life's misfortunes and setbacks. Resilience is an “inner strength” that helps us bounce back after stressful situations. It's how we face … worry when the going gets tough, we just don’t let these situations overwhelm us. Helping an injured employee build resilience is another element of the case management process. To … our life passions and the purpose we derive from events, experiences, beliefs, and values. In an article published by the American Psychological Association, it is stated that resilience …
News Release

Genex Patient Satisfaction Survey Reveals Five Factors That Matter Most to Injured Employees

… working with me on my recovery,” said one of the injured employees surveyed. "There was an issue between my doctor and the pharmacy, where I was not getting my required after-surgery … reason for their successful outcomes. Factors included setting realistic goals, obtaining an accurate job description and working with the employer to develop light-duty options to help … was very courteous and professional, I felt I really was in good hands, the hands of an angel helping me navigate through a difficult time.” …
Blog

Bringing value-based contracting to workers’ comp offers opportunities and challenges

… can be assured of collecting a simple, all-encompassing fee for seeing a patient through an episode of care. Value-based scenarios show up most often in realms such as specialty services … regardless of the number of services delivered to the patient. How to bill for care has become an urgent question in the last six months. With the U.S. still reeling from COVID-19, the disease … coronavirus, many providers have been struggling with a steep fall-off in patient visits and an attendant plunge in billing. Some policy experts are pointing to capitated scenarios as one …
Podcast

Providing a Lifeline to Flood Victims

… victims left homeless by the historic flooding. We recently caught up with Dykoff — who’s been an RN for 30 years, including the last 18 as a Genex case manager — to give us an assessment of the situation and the work she’s doing with the Red Cross.  … the shelter, we take care of all minor injuries but for anything significant we refer them to an urgent care or ER. I assess medical and functional needs and help the residents with any …
Article

Mitchell Collision Repair Industry Data: Q2 2018

… our servers was $3,267, compared to $3,329 in Q2 2017. Factoring for development produces an increase in the adjusted value to $3,292. average appraisal values, and age comprehensive … a $72 initial increase between these respective periods. Factoring for development yields an anticipated Q2 2018 adjusted appraisal value of $2,981, a $93 increase in average severity … Mitchell’s Q2 2018 data reflects an initial average gross collision appraisal value of $3,352, $57 more than the same period last …
Article

Mitchell Collision Repair Industry Data: Q1 2018

… our servers was $3,062, compared to $3,048 in Q1 2017. Factoring for development produces an increase in the adjusted value to $3,103.   Average Appraisal Values, ACVs and Age … a $135 initial increase between these respective periods. Factoring for development yields an anticipated Q1 2018 adjusted appraisal value of $ 2,978, a $156 increase in average severity … Values, ACVs and Age Auto Physical Damage Collision Losses Mitchell’s Q1 2018 data reflects an initial average gross collision appraisal value of $3,512, $155 more than the same period last …
Article

Understanding SB1160: The New California Utilization Review Process

… 1, 2018, and shall retain active accreditation while providing utilization review service, by an independent, nonprofit organization to certify that the utilization review process meets … during the first 30 days following the date of injury. During this 30-day treatment window in an accepted workers’ compensation claim, an injured worker, assuming that they are being treated by a medical provider network (MPN) or …
News Release

FDA Authorizes Pfizer/BioNTech COVID-19 Vaccine for Emergency Use

… On December 11, 2020, the U.S. Food and Drug Administration (FDA) granted an emergency use authorization (EUA) for the first severe acute respiratory syndrome coronavirus … from Moderna, Johnson & Johnson, Oxford/Astra Zeneca and others. According to the FDA , “an Emergency Use Authorization (EUA) is a mechanism available to FDA that facilitates the … vaccines, during public health emergencies, such as the current COVID-19 pandemic.” Under an EUA, the FDA may allow the use of unapproved medical products to diagnose, treat or prevent …
Article

Premiums Written: Q2 2019 Quarterly Must Read Round-Up

… share a podcast that I did with InsuranceJournal TV that’s all about how technology is making an impact on the workers’ compensation industry. Below I’ve included a link to the podcast and a … at candidate selection and moves through training and implementation in order to develop an effective physician peer review panel. In the second part of this two-part series, Jackie and … training. “Training of peer-review physicians, followed by monitoring and mentoring, is an approach to developing peer-review panels recommended in the latest Industry Trends Report …
News Release

FDA Approval of Dsuvia: Why Now and What Might it Mean for Workers' Compensation?

… of Defense to help provide rapid relief of pain on the battlefield in circumstances where an oral medication would not be practical or effective. For civilian use, Dsuvia is restricted to … committee voted to recommend its approval. Dr. Brown noted in his letter that Dsuvia “…is thus an extremely divertible drug, and I predict that we will encounter diversion, abuse, and death … payers would only see Dsuvia in very rare cases involving inpatient hospital settings where an injured worker was unable to receive pain medication through traditional routes of …
Article

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

… The insurance industry today has an experienced generation of adjusters, many of which have been in the industry their entire … insurance industry must update its workplace technology. These generations are going to demand an at-work experience that keeps pace with the way they use technology in their personal lives. Two-thirds of the millennial and Gen Z population consider an organization’s embrace of technology and innovation as an important factor when choosing an …
Article

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

… Texas employers who provide workers’ compensation coverage for their employees through an insurance policy or self-insurance program. In 2006, House Bill 7 reformed the system, … is approved by the treating doctor, reducing unnecessary specialty visits. We also maintain an expanded preauthorization list beyond state minimums to control utilization. Q: What are the benefits of accessing an HCN? A:  The biggest benefit is the ability to access PPO network contracted rates below the …
Article

Dave Torrence Gives His Perspective on the Benefits of Bringing Technology, Clinical and Networks Together

… like PBM and bill review, we have a unique perspective on how to put them all together in an optimized workflow to create the greatest value.  For example, we got into the PBM space … Dave: There is an enormous opportunity to leverage data from solutions across our businesses, and a multitude of … of clinical interventions. Maybe it’s a PBM claim that could benefit from case management or an independent medical exam. Those kinds of early clinical interventions would help further …
Podcast

Understanding ADA guidance for long COVID disability

… Epstein‑Barr or chronic fatigue — issues we have seen for 20 to 30 years — with people having an acute phase of a disease and then there are lingering symptoms that impact functioning on a … it might affect a person’s activities of daily living. So, there’s a recognition that COVID is an issue in terms of people’s ability to handle work duties as well as activities of daily living. … individuals in the population, I think there will probably be, in the next one to three years, an increase in short‑term and long‑term disability claims and probably Social Security disability …
Article

Michigan Auto No-Fault Reform: History and Overview

… In this article, I will walk you through the history of auto insurance in Michigan and provide an overview of the new Michigan no-fault reform regulations. … auto insurance market has operated under a no-fault system, meaning that when a driver gets in an accident, they are required to file a claim with their own insurance carrier regardless of if … Today, the state of Michigan does not have an auto fee schedule, meaning that across the board, insurance carriers are using different …
Article

Is Your Collision Repair Facility Ready for Electric Vehicles?

…   By 2022, owning an electric vehicle will be as cheap as owning one that runs on fossil fuels, and sales will grow … by 2023. VW plans to build 22 million electric cars in ten years. Daimler plans to offer an electrified variant for every model in its portfolio. According to a recent report from Deloitte, electric cars are nearing a tipping point. By 2022, “owning an electric vehicle will be as cheap as owning one that runs on fossil fuels, and sales will grow …
Article

Is the Supply Chain Creating Critical Drug Shortages?

… Regardless, delayed access to maintenance drugs for additional chronic conditions can have an impact on injured worker treatment and recovery. An important point to note is that about 80 percent of active pharmaceutical ingredient …
White Paper

Substance Misuse Recovery Network

… nation has made in reducing opioid prescriptions, misuse of these powerful analgesics remains an intractable problem. And while much work remains, the health care system has grown more adept … treatment of injured workers, who often face the dual challenge of requiring assistance with an opioid use disorder while trying to endure the strains that can arise from being away from …
Article

Basics of Workers' Compensation Pharmacy Benefit Management [Video]

… MED stands for Morphine Equivalent Dose and is an important consideration when prescribing opioids. Learn how MED is used to determine the potency of a particular opioid, plus how to calculate the MED of an opioid. …
News Release

Three States Look at Legislation for Auto Personal Injury Protection

… HB 301 states that if an insurer has provided notice that it may limit reimbursement based on the fee schedule, … HB 1233 would increase the PIP limit from $10,000 to $25,000 and add an option to purchase up to $75,000. …