Article

Settling Future Medical? Don’t Let Medicare Turn It Into a Reopen

… When an MSA should be on your radar … An MSA allocates and projects future treatment, but it only includes medical services and medications that would be covered by Medicare. That is the sharp line between an MSA and a broader medical cost projection. …
News Release

Mitchell Expands Its Intelligent Open Platform and Support for AI-Enabled Vehicle Inspections Through Collaboration With PAVE

… —Mitchell, an Enlyte company and leading technology and information provider for the  Property & Casualty … for parts, labor, repair or replace operations, and regional taxes.     “PAVE has developed an advanced, AI-powered solution for virtual vehicle inspections,” said Steve Southin, co-CEO and … PAVE is an automotive technology company reimagining how the world inspects vehicles. Powered by …
Article

Examining Social Determinants of Health: The Whole Person Approach

… are in their journey to recovery?  Social determinants of health , or the conditions in which an individual lives, works, learns, and plays, are a big part of the answer to any of these … clinical programs avoid the pitfalls of treating the primary diagnosis only. They can act as an advocate , looking at the whole person to identify those social determinants of health that … groups respond to COVID-19 and with COVID-19 vaccination rates . Social determinants play an outsized role because, in many ways, they represent the rest of our story — the part that is …
Article

Average Length of Rental for Repairable Vehicles: Q1 2020

… Average Length of Rental (LOR) for Q1 2020 in the U.S. was 13.2 days, showing an increase of 0.4 days compared to the same quarter in 2019 . A total of nine states had lower … difference between “average” and “best-in-class” results. Collision centers that invest in an effective scheduling strategy, extensive employee training and proper utilization of the ARMS® … difference between “average” and “best-in-class” results. Collision centers that invest in an effective scheduling strategy, extensive employee training and proper utilization of the ARMS® …
Blog

My Way, Right Now

… with a company, whether through their website, mobile app, or even over the phone, could cause an otherwise loyal customer to go to a competitor.  Each experience provided by a company is an opportunity to gain a new customer, retain an existing customer, or lose a customer. Each customer has different needs, different …
Blog

Understanding Brand & Generic Utilization and Cost

… contain the same active ingredient and approved indications as their brand name counterparts. An increase of 0.6% might not seem like a lot; however, when the difference in cost per script is … uses step therapy rules, automated prior authorization messaging, outreach, and education in an attempt control the use of medications that fall into this category. It is worth noting that … like this one that address specific drug trends highlighted in the series, and if you miss an edition our series, please visit our  Drug Trends Page .  1 Aggregate value includes First …
Article

Off Patent Medications & Drug Patent Expiration: Quarterly Drug Update

… Anti-retroviral combination drug (treats HIV). This medication may be used short-term after an accidental needle-exposure. … Anti-retroviral combination drug (treats HIV). This medication may be used short-term after an accidental needle-exposure. … which treats heartburn/gastrointestinal reflux disease and sodium bicarbonate, which is an antacid. This is available as Zegerid OTC (over-the counter medication). …
Article

The Importance of Automotive Diagnostics in Collision Repair

… Use an aftermarket tool: … complete repair services to their customers, reduce cycle time and be compensated by insurers, an affordable in-house scan tool specifically designed and developed for collision repair shops is an absolute must. 1 Does Your Body Shop Need a Scan Tool?   BodyShop Business ., 03 Feb. 2012. …
Article

How (Humane) Claims Automation Leverages Technology for Better Outcomes

… claims workflows using well-established technology like business rules engines has long been an industry go-to, and will undoubtedly remain a valuable mainstay, even as companies … them with more time to focus on human-centered work and complex decision-making. With an increased focus on the most complex claims, there are increasing opportunities to improve … to help insurers make better vehicle repair decisions.  Mitchell’s Assisted Review is an AI enabled process. The process works by using millions of damaged vehicle photos. Algorithms …
Article

How Medical Inflation is Affecting Workers’ Compensation Claims

… per unit in 2021, allowed per unit only increased 2%. Both California and Texas experienced an 8% increase in charge per unit and an 11% increase in allowed per unit. Medical Inflation by Service Group Worker's Comp Medical … 35% increase in medicine services, a 22% increase in office and other outpatient services and an 8% increase in physical medicine and rehabilitation. The allowed per claim index for three of …
Article

Today's Forecast Calls for Clinical Intervention

… I grew up in an area of the country where it rarely snowed, but when it did, it was difficult to predict. … and pharmacy data, and integrating that with treatment and return-to-work guidelines builds an accurate picture of the individual as the claim matures and allows us to identify risk … of narrative text to help identify the non-coded but documented granular insights about an injured employee. This is particularly helpful in identifying Social Determinants of Health …
Article

How Diagnostics Improve the Auto Insurance Claim Process

… that you needed to fix a dented vehicle was a hammer and dolly. Flash-forward to today. With an excess of 75 computers and 100 sensors and cameras in complex vehicles 1 , even the most basic … of a vehicle's value by 2020 is projected to derive from automotive electronics and software, an increase from 23 percent in 2000 .” 4 … Introducing vehicle diagnostics into the claims process when necessary is an advantage to the vehicle owner because the collision repair technician has a more complete …
Article

Generic Medications: Quarterly Drug Update

… a workers’ compensation or auto accident-related claim is vital to ensure the best outcomes. An important area to monitor during claims is the usage of brand name medications when generic … Treats insomnia. Many people have difficulty sleeping after an injury due to the pain/inflammation. Medications used to treat insomnia should only be used … This is mainly an anti-seizure medication. However, it is used primarily in the workers' compensation space to …
Article

Field Inspection vs Virtual Estimating Trends

… inspection at the vehicle’s location if within a staff member’s territory; or inspection by an independent appraiser. Less commonly employed options include, service centers operated by the … more than doubled. The general trend appears to be a reduction in staff field inspections and an increase in insurance-administered PBE, with staff reductions resulting in additional IA … and the use of historical estimate data, software will soon be able to reliably create an estimate that can be quickly affirmed or edited by an appraiser. photo based estimating images …
Article

Average Length of Rental for Repairable Vehicles: Q1 2018

… Q1 2018 Average Length of Rental (LOR) for Q1 2018 landed at 12.5 days in the United States, an increase of .4 days compared to Q1 2017. This represents a return to the consistent upward … and 1 day longer than the Q1 2017 result of 11.7 days. While the United States also witnessed an LOR increase—.4 days—through the first 90 days of 2018, (from 12.1 days to 12.5 days), January … results in Canada for Q1 2018. Prince Edward Island was the sole province that did not see an increase over Q1 2017 (remaining fat at 9.5 days), while six provinces posted an increase over …
Blog

A Look Back at 40 Years

… not adapt, does not stay in business long. And Genex could not be experiencing 40 years as an industry‑leading firm, had we not evolved with strength or actually rolled with some of the … : This is an interesting question. The first one would be when early Genex leadership focused on a fully … our core capability with field case management. The market differentiation that has come with an end‑to‑end solution, I think has resulted in being a brand catalyst for us. No. 3, I would say …
Article

What Does Network Security Look Like When There Is No Perimeter?

… and CIOs to do? Sticking with past solutions and incrementally improving upon them is no more an option than finding a shiny, new, silver bullet. And unlike Bank of America , most enterprises … term, I believe layering in identity-defined security, in which access is not only tied to an individual user, but also to the context in which he or she is accessing certain information, … access. Through automation, a network with identity-defined security could efficiently manage an unlimited number of identities. Further, it could be deployed on premises, in a cloud solution …
Virtual Event

Michigan No-Fault Fee Schedule: What You Need to Know Before July 2

… on June 23 at 9:30 AM PT , Mitchell regulatory, product and industry experts will provide an update on the latest information, including what is still outstanding, and share key … may want to address the ambiguity and prepare for the effective date. They’ll also provide an update on Mitchell’s product strategy related to the new fee schedule. …
Case Study

Healing Body and Soul

… Schwartz was assigned a case involving an injured construction worker who was recovering from a fractured leg. The worker not only … skill in working closely with providers helped her keep the treatments on track and obtain an early release that would return the construction worker back to his job ahead of schedule, …
Article

Specialty Solutions Spotlight: Diagnostic Imaging Services in Workers’ Compensation

… areas with elevated metabolic activity, indicating the location of the disease. A PET scan is an effective way to diagnose traumatic brain injuries.   Electrodiagnostics Electrodiagnostics is … An EMG captures muscle electrical activity and presents it visually or in a signal. This … collected through a set of electrodes, placed on the skin surface or inserted into the muscle. An EMG test can assess back or neck issues and may be prescribed for injured employees …
Blog

Top-Ranking Drug Classes in 2019

… a deeper dive into some of the therapeutic classes showing the biggest increases among the top 10 ranked by cost from our 2019 analysis. … cost per claim (up 1.0%), and cost per script (up 0.2%). Except for opioids, the remaining top 10 therapeutic classes experienced increased utilization per claim, however, most by 3% or … common. Again, an 11.2% increase in utilization was seen for this class from 2018 to 2019. The top contributors to cost within the topical class include prescription topical Nonsteroidal …
Blog

Beyond the Status Quo

… having been correctly applied and facing a failing patient, his doctors gave George Washington an enema – and he died. The sad takeaway is that if he would have received no treatment and had … to confirm demographic updates. The highly transitory nature of medical practices led to an industry mindset that to be the “best” with provider directories, you just had to do “more and … folded into the process to further enhance the accuracy of the provider directory information. An ongoing evaluation of HIPAA compliant block chain opportunities is also under way. The …
Article

Measuring the Impact of Case Management

… methodology to demonstrate medical savings and lost time avoidance. These savings represent an “estimate” of potential savings associated with case management services and should be viewed as an early indicator that case management is making a positive impact on claims and a predictor of … the safe and rapid return to work of injured employees. According to the Oxford Dictionary, an impact is 'a marked effect or influence.' Within a case management program, the impact on a …
Blog

Not all victims of workplace trauma sustain physical injuries

… so is not only the right thing to do, but it can also prevent losses to productivity at both an individual and organizational level. Besides outward physical violence, mental trauma should … a traumatic event does not just affect the people directly involved, it can also have an impact on bystanders and people close to those involved. Having face-to-face counseling … Manager was called to a small family owned truck stop, where due to a violent incident, an employee had been killed at work. She individually met with the three other employees. In her …
Blog

What's the difference between a drug allergy and a side effect?

… very serious, resulting from the activation and response of your body’s immune system to an “insult” or “foreign body”.  Allergies range in severity, from mild to life-threatening, and … injections may be used to treat anaphylaxis. Medications, Supplements, and Vitamins all have an expected  range of physiologic effects when they are consumed. The desired, therapeutic effect … Prevention of both include some strategies in common, such as identification and avoidance. An important difference in these is recognizing the contribution to serious allergic reactions of …
Blog

What moved the state of Ohio to drop OxyContin® from their formulary?

… evolved. A review of opioid use in the injured worker population, completed in 2011, revealed an alarming number (73%) were filling opioid prescriptions. 1 A closed formulary, expanded access … committee voted to retain a single, extended-release oxycodone product, XTampza® ER , an “abuse-deterrent” product, on the formulary. “XTampza is a sustained-release form of … on addressing the opioid crisis, said the move was a step in the right direction. “When an on-the-job injury causes someone serious discomfort, we want that worker to get the needed …
News Release

Montana to Hold Hearing on Proposed Drug Formulary Rule

… are required to respond to a request for prior authorization within three business days If an insurer fails to respond within the three day time frame, the medication is considered approved for that fill only An insurer may delegate the prior authorization process to a PBM or other entity with which it … unable to transition and provide a treatment plan for prior authorization The rule establishes an expedited case review by the DLI medical director in emergency situations when the insurance …
News Release

FDA Authorizes Use of First at Home COVID-19 Test Kit

… a 94% positive percent agreement and a 98% negative percent agreement when compared to an FDA authorized high sensitivity SARS-CoV-2 test. The test takes about 30 minutes and an indicator light will note a positive or negative result. Individuals with positive tests …