News Release

Kentucky Administrative Rule Updates

… Utilization Review program: KAR 803 25:195E and KAR 803 35:195 Proposed.  KAR 803 25:195E is an emergency rule in effect as of April 15, 2022.  KAR 803 35:195 Proposed is the same as the emergency rule but will be … This meant there would be no KY regulations governing UR and MBA, hence the emergency adoption of 803 KAR 25:195E. The proposed changes include, but are not limited to, the following: Adds new …
Case Study

ClinicalCare24 Demonstrated Results

… We Hear Countless Success Stories Every Day, So We Thought We’d Share When an on-the-job injury occurs, the initial response can be critical in aiding an employee in making the right decisions about what type of care they need. Employees need to trust that their employer will support them with the … with a resource that can assess the situation and help determine the appropriate course of action. Whether it be self-care or an urgent care, having a Registered Nurse (RN) who is armed …
Podcast

Demystifying the MSA

… to fund future accident-related treatment in workers' comp settlements. However, because of the complex nature of the MSA, too often employers will go the MSA route when there are better options available. In … Deborah, what are some of the major concerns payers have when dealing with an MSA? … : One of the biggest concerns that they have is, will they be able to settle the file? Oftentimes, when you get in a Medicare Set‑Aside, your vision of what the file will settle for can greatly increase because the Medicare Set‑Aside may inflate …
Article

5 COVID-19 Security Threats to Know About

… Some studies estimate that more than half of the workforce is working from home amidst the COVID-19 crisis, and many companies have already announced plans to allow employees to work remotely even after the threat of the virus has subsided. While working from home has helped social distancing efforts across the country, it has also opened up companies to an onslaught of new security threats. … The COVID-19 pandemic has brought about a variety of security challenges for companies and individuals around the world. For example, the U.S. saw …
News Release

Genex Case Managers' Survey Delivers Strategies to Avoid Claim Pitfalls

… Communication issues cause of most problems in setting course of case, experts say … for employers and insurers. For this reason, Genex Services, the nation's largest provider of workers' compensation clinical services,   recently interviewed more than 200 of its expert … proper management. However, a few stood out as the leading risks.  Here are some of the top pitfalls and summary responses on how to avoid them. …
Article

Premiums Written: Q4 2019 Casualty Must Read Round-Up

… Each quarter, I round up and highlight some of my favorite articles written by Mitchell experts and let you know where we have been published outside of our mPower thought leadership website. This quarter, I’m excited to highlight an article from Rebecca Morgan, senior director of product management at Mitchell, which was … Viewpoint: The Power of an Optimized Workflow for Claims Adjusters … By DoxTek Mitchell was recently honored by its partner DoxTek with an award for excellence in training and certifications at its conference Connexion 2019. Appeared …
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 … tiny needles strategically positioned in the ear to relieve symptoms during the early stages of withdrawal, including, but not limited to, agitation, anxiety, depression, nausea, and cravings, and is designed to increase the level of comfort and mobility for the claimant.  The …
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 … tiny needles strategically positioned in the ear to relieve symptoms during the early stages of withdrawal, including, but not limited to, agitation, anxiety, depression, nausea, and cravings, and is designed to increase the level of comfort and mobility for the claimant.  The …
Blog

In Workers’ Comp, the Topics We Talk about Will Continue to Broaden in 2020

… that things aren’t moving fast enough. Some topics have been mainstays in the industry. Think of opioid use, misuse, and abuse; return-to-work programs; ergonomics and safety; new and … management. But not every discussion point has been around for years.  As I look back at some of the things that we discussed in 2019, several represent topics we haven’t spent an inordinate amount of time on previously. These include opportunities for virtual connections …
News Release

New York Workers' Compensation Board Clarifies Opioid Tax Rule

… Cuomo signed S1509, a comprehensive budget bill. Included in the bill was the creation of Article 20-D, imposing an excise tax on opioids. The tax is to be imposed on the “first sale” of every opioid unit into New York State. The law specifically excludes the “dispensing of an …
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, … : So, one of the things that we’re seeing is that remote work is continuing to stay, right? So, prior to … the overall economy, consumer spending is actually over 50 percent of the US economy. So, from an innovation standpoint and from a consumer-spending standpoint, that’s where a lot of …
Article

7 Tips for Managing Prosthetics in Workers’ Compensation

… costs associated with prosthetics require detailed attention to ensure both the well-being of the injured employee and cost-effective management. Here are key insights and strategies to … 1. Understand the Importance of Prosthetics … Prosthetics do more than just replace a lost limb; they play a pivotal part in an injured employee’s rehabilitation and reintegration into their work and daily life. Ensuring …
Article

Medicare proposed rulemaking and enhancements to the MSP Recovery Portal

… settlements involving automobile and liability insurance including no fault insurance. The aim of the proposed rule 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 … 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, the bid …
Article

Medicare proposed rulemaking and enhancements to the MSP Recovery Portal

… settlements involving automobile and liability insurance including no fault insurance. The aim of the proposed rule 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 … 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, the bid …
Article

Five Things You May Not Know About Your Case Manager

… What I enjoy most about my job is sharing the important work of those whom I consider to be the life-changing forces of workers’ comp: nurse case managers. Still, it can be a challenge to tell these stories because … a case manager does . Considering there are more than 3 million nurses working in every facet of health care in the United States, it’s no surprise that this unique specialty isn’t as … They’re on the front lines of stopping opioid abuse. …
Article

Health Literacy’s Impact on Delayed Recovery

… This article is authored by guest blogger, Mariellen Blue, National Director of Case 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 … can be difficult to understand—particularly if injured employees are distracted with feelings of fear and anxiety during medical appointments, as they may be worried about their injury and …
News Release

Empower Your Customers and Appraisers with Photo-Based Estimating

… The introduction of photo-based estimating brings insurance carriers great benefits such as increased efficiency and cost-effective resource management. The process of sending an appraiser to drive out to see a vehicle in person and complete an estimate on a relatively …
Article

Reflecting on 2017: Predictions for 2018 in Workers’ Compensation

… fact that many states have enacted laws or regulations imposing controls on the prescribing of opioid medications. Additionally, the Utah Insurance Department recently compiled a report … policies by health and workers’ compensation insurers. This report indicated that a number of health plans, though allegedly following CDC guidelines, still don’t trigger a hard review of an opioid prescription unless the daily morphine equivalent (MED) dose exceeds 200. The CDC …
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.  … With specialized care, it trickles down into the home health space because first, right out of schooling, these professionals may not have the experience yet to go directly into home health …
Article

From RPA to Cobots: Automation in Insurance and Collision Repair

… The potential 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 professionals. The following is a roundup of three must-know types of automation that have the potential to transform the entire ecosystem, … In its simplest form, robotic process automation (RPA) is the automation of repetitive tasks that humans would normally do. RPA can automate both front and back office …
Article

New Year Resolutions to Make With Your PBM

… The New Year brings a slew of goals and renewal in all areas of our lives. What about your PBM program? Here’s our quick list of considerations to get your program in shape for the new year. … to address the opioid crisis. For instance, South Carolina’s governor recently signed an executive order to limit first-fill opioid prescriptions. Consider how you want to approach … medical marijuana in workers’ compensation claims , while others are focusing on the issue of workplace safety and employer versus employee rights. How can your PBM help you navigate this …
Article

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

… and other hospital visits can be costly for insurance carriers, as facility charges are some of the highest fees that carriers face when paying for medical treatments related to auto accidents. In fact, a recent Mitchell analysis of third party bills revealed that while inpatient facility bills represented only 1% of all of the bills a carrier evaluated, they made up almost 11% of total charges evaluated. …
News Release

Florida Governor Signs Opioid Legislation

… release about the bill signing, Governor Scott said, “This bill will help limit the chance of drug addiction, reduce the ability for dangerous drugs to spread in Florida's communities and … vulnerable Floridians needed support.” The bill will promote important changes in a number of areas that should make great strides in helping Florida combat the opioid problem.   Highlights of the legislation include: …
Podcast

What to Look for When Choosing a Provider Network

… let's start with this. When payers are looking to pair with a provider network, what are some of the key qualities they should look for? … to want to start with making sure you have access to a large national 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 … place — that regularly review provider credential processes, that include ongoing monitoring of physician licenses, any sanctions, or quality issues, as well as feedback mechanisms from …
Article

Consumer Self-Service Expectations are the New Normal

… In 2016, smartphone ownership for individuals 13 years of age and older surpassed 81% in the United States, effectively reaching full market saturation. … to expect information and service, anywhere and anytime—with no more effort than the swipe of a finger. So let’s put that impact into perspective. Mobile technology influenced changes in … 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 …
Podcast

Treating LGBTQ Injured Workers: Gaining Cultural Competence, Building Trust

… based on sexual orientation have become more prevalent, with statistics to prove it. Lack of trust between patient and provider can have a significant impact in workers’ comp, says Genex … MSN, RN, CCM, who explains how bias and cultural misunderstanding can significantly delay an injured worker’s recovery. For more information on the topic, read Chikita's full article in … Chikita, what are some common misconceptions in treating members of the LGBTQ community? …
Article

Ask The Pharmacist: Steroid Medications in Workers’ Compensation

… What are the various kinds of steroid medications?  … In workers’ comp, steroid medications have often played a role in the management of pain related conditions and joint injuries, either alone or incorporated in “trigger point” injections with an anesthetic medication like lidocaine. They are also used to reduce inflammation in the …
Article

Return to Work Program Benefits & Strategies

… your objectives? Mitchell Chief Clinical Officer, Dr. Mitch Freeman, Genex Services Senior VP of Utilization Management, Helen Froehlich, and Genex Services Vice President of Analytics and Reporting, Jim Harris, addressed these challenges during a recent session at Mitchell’s annual mPower conference. Here are some of their key points for return to work program benefits & strategies. … A successful return to work program requires coordination of various factors, with the main emphasis on the injured employee. Developing the plan early in …