News Release

Primary Point of Impact Contributing to Differences in Claims Severity for Battery Electric and Internal Combustion Engine Vehicles

… are more likely than their electrified counterparts to sustain costly front-end damage in an accident. … —Mitchell, an Enlyte company and leading technology and information provider for the  Property & Casualty (P&C) claims and  Collision Repair industries, today announced the release of its Q3 2024 Plugged-In: EV Collision Insights report. This issue provides an overview of the point-of-impact and severity differences between repairable battery electric vehicles …
Article

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

… Medical expenses, now 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 average is expected to climb even higher in … Utilization review is the process of reviewing medical services for the purpose of monitoring the quality and appropriateness of care. Using nationally recognized treatment …
Virtual Event

The State of Pharmacy Trends in Workers' Comp

… care in workers’ compensation. While opioids continue to represent a decreasing portion of overall prescriptions and costs, other retail and mail order medications have seen … seeing double-digit cost increases. Additional cost drivers include physician dispensing of high dollar topicals and rising migraine medication utilization.  Opioids, emerging drug … The complete view of in- and out-of-network pharmacy trends A deeper perspective on the top pharmacy trends How to best equip your pharmacy program for success …
Article

Seamless Management of Specialty Services for Catastrophic Claims
Article

Seamless Management of Specialty Services for Catastrophic Claims
Case Study

2022 Catastrophic Heart of Case Management Award Winner

… The devastating event resulted in eight fatalities as rescue crews continued to free dozens of employees from debris. To handle the number of injured, employees were taken to five hospitals in the area. Harrell received survivors at … She worked weekends, sometimes putting in as much as 16 hours a day to ensure continuity of care. The injured employees she managed sustained various degrees of injury from burns to …
News Release

Severity, cost of comp claims on the rise

… The workers' compensation sector remains a relatively stable and profitable segment of the commercial insurance industry, but some claims are getting pricier and concerns over …
Case Study

2021 Disability Heart of Case Management Award Winner

… The Heart of Case Management Award is a national program recognizing case managers who are highly regarded for transcending beyond their traditional job duties to improve the lives of thousands of injured employees. Watch the video and read the cases below to learn how our Disability Case … care plan. To complicate matters, the man tested positive for COVID-19 during the height of the pandemic, which delayed the procedure. Instead, he received temporary grafts and was …
News Release

Industrial Commission of Arizona Adopts New Fee Schedule

… Earlier this year, the Industrial Commission of Arizona (ICA) released a proposed fee schedule for the coming year and a public hearing was held on July 29, 2021. A number of stakeholders offered comments at the hearing and submitted written comments. The Commission … based on stakeholder input. On September 2, 2021, the ICA approved their revised version of the 2021-2022 Physician and Pharmaceutical Fee Schedule. The new fee schedule will be …
News Release

Tennessee Declares a State of Emergency Following Severe Storms

… The Tennessee Emergency Management Agency (TEMA) has declared a state of emergency for the entire state in the aftermath of severe storms that also spawned tornadoes in West and Middle Tennessee. The impacted areas saw …
News Release

Tennessee Declares a State of Emergency Following Severe Storms

… The Tennessee Emergency Management Agency (TEMA) has declared a state of emergency for the entire state in the aftermath of severe storms that also spawned tornadoes in West and Middle Tennessee. The impacted areas saw …
News Release

Tennessee Declares a State of Emergency Following Severe Storms

… The Tennessee Emergency Management Agency (TEMA) has declared a state of emergency for the entire state in the aftermath of severe storms that also spawned tornadoes in West and Middle Tennessee. The impacted areas saw … to obtain longer fills, earlier refills and other considerations to help maintain continuity of pharmacy care during this period of emergency. Our thoughts are with the people of Tennessee …
Article

The Future of Pain Therapy in Workers’ Compensation

… therapy, home exercise programs and electrical therapy treatments. What about the future of pain medication? Opioids can be effective for treating pain, but come with many adverse side effects—the worst of which are dependence or addiction. However, there are a few options on the horizon that could … the nociceptin/orphanin FQ peptide (NOP) receptor, which may prevent the unwanted side effects of current opioids. The pre-clinical studies show promise: A dose of AT-121 was able to “ …
News Release

Property & Casualty in the Age of Humane Automation
Article

CMS Releases Version 2.9 of WCMSA Reference Guide

… provides. Here we are a few days into a new year and CMS has released and updated version of the WCMSA Reference Guide. As you may recall CMS issued Version 2.8 of the WCMSA Reference Guide just a few months ago in the Fall of 2018. Version 2.9 of the Guide includes the following changes: The CMS development letter, … include additional information regarding SCS replacements and revisions.  Routine replacement of the neurostimulator pulse generator includes the lead implantation up to the number of leads …
Case Study

The Rise of a Real-life Robocop: Meet Jeremy

… and success in the field. Each year, nominations are received and reviewed by a panel of industry judges who make the final determination for honorees.  For more stories like this, …
Blog

Sneak Peek: The Rise of a Real-life Robocop

… Romero’s story in a can’t-miss video. You’ll learn how he faced these challenges with the help of influential advocates who opened doors and walked with him every step of the way. In the meantime, meet Jeremy in this special podcast preview. …
Article

WC Magazine: The New Cost of Mistaken Identity

… Misclassifying Their Independent Contractors? A recent WC Magazine article, "The New Cost of Mistaken Identity," spotlights liability risks workers’ compensation payers may face in … contractors to avoid paying certain wages, benefits and taxes. With recent Department of Labor (DOL) initiatives designed to stop the practice, this article details the legalities of classification and examines vendor relationships to reduce potential risk. To obtain a deeper …
Article

COVID-19 P&C Industry Update: Regulations, Telemedicine, Access to Care and Testing

… Over the past few months, the property and casualty industry has experienced an unprecedented number of changes in a short period of time due to the COVID-19 pandemic. From a slew of regulatory updates and working remotely to … The regulatory landscape went from a planned and predictable agenda to an atmosphere of executive orders, emergency bulletins and quick passage of legislation and administrative …
News Release

Mitchell's Third Quarter 2020 Industry Trends Report Explores P&C Trends in the Age of COVID-19

… —Mitchell International, a leading provider of technology, connectivity and information solutions to the property & casualty claims and … "We're starting to see important new patterns emerge as we move into the second half of 2020," said President and CEO Alex Sun. "Understanding and responding to these trends will be … they serve are the significant drivers of new innovations and technologies, we continue to see an accelerated pace of adoption driven by COVID-19 and we expect to see new needs arise as the …
News Release

Genex Services White Paper Examines the Tipping Points of Routine Workers' Compensation Claims

… Highlights value of early case management intervention for optimal RTW … — Genex Services, the nation's largest provider of managed care services for employers and insurance carriers, explores the provocative question of, “Where is the tipping point in a seemingly routine workers' compensation claim?” in its … for even routine injuries when two or more red flags are identified,” says Chavanu. “As an industry, we have to move away from setting arbitrary dollar figures for when to bring in case …
Article

The Power of Advanced Reporting & Analytics: Highlighting Actionable Insights in the Claims Process

… Analytics has been a hot topic for a few years now, and for good reason. More than half of analytics leaders reported a correlation between their organization’s analytics initiatives … improvement” in their competitive standing. In the coming year, more than three quarters of that same group plan to expand or modernize their IT infrastructure to support analytics, … of CEOs at a variety of major P&C insurance carriers that they surveyed consider analytics a top priority, only one in six responded that analytics was making a large impact. The reasons for …
News Release

Stone Point Capital Completes Acquisition of Genex Services from Funds Advised by Apax Partners

… Genex Services (“Genex”), a leading provider of cost containment services to the workers' compensation, disability, and auto industries, … , a global private equity firm. Financial terms of the transaction were not disclosed. Founded in 1978, Genex helped introduce the medical management concept and has grown into one of the largest and most experienced … 380 of the Fortune 500 companies … , addressing the unique needs of each organization and employee—one relationship at a time. …
News Release

September 2022 Utilization Review Compliance Update

… As your utilization review (UR) vendor, we want to keep you informed of regulation updates that impact the UR business. If you have any questions about any of the information presented, please do not hesitate to contact your client account manager. Or you may reach out to a member of the Genex UR Compliance team whose … Tennessee UR is governed by Chapter 0800-02-06 of the TN Department of Labor and Workforce Development Bureau of Workers’ Compensation These …
Article

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

… With an effective date of January 1, 2018 for California Senate Bill (SB) 1160 rapidly closing in, many stakeholders in our industry are continuing to analyze the kind of impact the bill may have for injured workers receiving quicker access to medical treatment, … Utilization Review: Removal of Prospective Review … SB 1160 focuses primarily on provisions related to workers’ compensation UR and liens; with one of the most interesting provisions being that medical treatment for injured workers will not be …
Article

The Power of Smarter Solutions: Three Ways to Facilitate Better Decision Making with Claims Automation

… can result in improved claim outcomes. Click here to read the first article “The Power of Technology Integration: Six Ways to Use Technology to Improve Claim Outcomes. " Automation has been a part of the workers’ compensation and auto casualty industries for years, but today, a large … opportunity still remains to increase automation in the medical claims process . The future of claims automation in the Property & Casualty industry is not to replace jobs but instead to …
In the News

A Breakthrough in Pain Management: Inside the Promise of Journavx
Article

Revving Up Reform: The Future of Michigan’s Auto Insurance

… notoriously high premiums. Key changes included allowing drivers to choose lower levels of personal injury protection (PIP) coverage, implementing a fee schedule for medical services, and prohibiting the use of certain non-driving factors in rate determination. Fast forward to 2025, and the political … a 28% rise nationwide. Despite this relatively modest increase, Michigan still ranks among the top ten states with the most expensive car insurance. Insurance fraud remains a significant …