Article

Insurance Chatbots Are Transforming The Industry With Automation

… Facebook Messenger, there were 34,000 of them on the platform. But just what are they and why do they matter? First, it’s important to understand that the term ‘bot’ encompasses many … rules-based (non-cognitive) software that automates repetitive tasks. They can fill out forms, do data entry, even import and export data between two systems. They are fast and accurate, save … ordering tacos from a simple transaction to transformative customer experience. Chatbots can do a whole lot more than satisfy your taco cravings. Bank of America’s Erica, sends you …
Podcast

Return-to-work strategies for LGBTQ+ Injured Employees

… It's great to be here. I'm glad to be able to do this with you. … able to have those annual visits. So, if you don't trust your health care professional, if you do not feel that you're going to be taken seriously, if you are constantly dealing with … So, they may not end up going to the doctor for those annual visits. And so, when they do have an issue that comes up, when they finally do go to the doctor, it's almost a plethora of …
Article

Tame the Chaos: How to Use Data to Bring Structure to Claims

… data analytics and AI. It's about how we're going to wrangle that unstructured data.   And how do we do that? Well, it starts by using subject matter experts to help identify the salient points in … surgery or things along that line as well allows both organizations to really stay on top of what's happening here.     … So, where do you see data playing a crucial role in reducing unnecessary steps? And errors in the clients’ …
Podcast

Calculating the Value of Evidence-Based PT

… care. It’s the reason a lot of us get into therapy, to work with patients directly and do that manual therapy. Early in my career, I used to think that was the most important thing, … as denying care, right? Patients often get very frustrated if you say, “oh, we’re not going to do this approach” or they ask about a treatment that may not be supported by evidence. They might … of providers out there — tens of thousands available clinics — most of these practices do less than 10 percent workers’ comp, because the biggest payers are Medicare and group health. …
Article

What You Need to Know About Extended Reality

… to help manage the impact of COVID-19, XR has become increasingly attractive as a way to do more while still maintaining social distancing. … AR enhances an existing environment with additional data. Snapchat has been teaching us how to do this for years, with their “lenses” that adjust to our faces—and even our pets—in real time. … ability transform the way we interact with customers, our colleagues, and the work we need to do, both now and in the future. …
Article

State by State Marijuana Laws

… states approving ballot initiatives to legalize the drug. As we move into 2021, what updates do you need to know? Below is an interactive map showing the updated landscape of marijuana … what is acceptable. Beyond that, most states have not set any precedent for what insurers must do in the face of a workers’ compensation claim involving medical marijuana. A few have made headway in this area, but often these rulings are a case-by-case basis and do not set a hardline standard for all claims. Only a handful of states have required medical …
Podcast

Restoring Lives: How Heart of Case Management Award Winners Make a Difference

… all the equipment that typically you would go home with from an acute rehab. He was able to do a first‑floor setup, which was helpful. Didn’t need any modifications other than a ramp … to come to bring his wife with him to appointments or if he had other activities he needed to do, because, being Amish, he didn’t drive. But then being paraplegic and his wife being Amish, … wheelchair, all the other equipment an individual would need going home. And I needed to do a home visit after he was discharged per the insurance company to make sure that what he was …
Podcast

The PAID Act is Coming to Medicare—Are You Ready?

… traditional Medicare and that’s your Part A and Part B Medicare benefit information when they do a Section 111 query. So, for those that may not know, Section 111 is the Mandatory Insurer … So, on Dec. 11, 2021, CMS will begin to provide these carriers and insurers when they do this query process with up to three years of beneficiary enrollment data for the Part C and … of where they need to make payments in terms of reimbursing Medicare. So, right now, when you do a query inquiry through the Section 111 process, you’re only going to uncover Part A and Part …
Article

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

… and networks together as one family of businesses. As the Pharmacy Solutions leader, how do you see these areas working together?  … as a bill review company, where we could optimize pharmacy. We recognized the opportunity to do what other PBMs were not doing because they didn’t have the same insight due to our unique purview into the bill review solution and how to integrate it with the PBM. Today, we do this in a way that no one else in the industry does.  Whether it's PBM and bill review, …
Article

A Team Approach to Building a Better Return-to-Work Program

… When you talk about the job analysis, do case managers often check to see if it matches what the injured worker does on the job? … Yes, we do. My customer has a bank of job descriptions or job analysis. They are reviewed and updated by … part of the RTW process — being knowledgeable of the light‑duty tasks available that they can do safely — they feel comfortable. They want to return to work. This assists the provider in …
Article

10 Questions Every Injured Employee Should Ask When Taking Opioids

… many other medications also contain acetaminophen. This includes over-the-counter medications. Do not take other medications with acetaminophen in them unless your doctor has told you to. Talk … Do not drive or operate machinery … tolerance and withdrawal may not mean that you have opioid use disorder. #5 What should you do if you think you may have a problem with opioids? If you think you may have a problem with …
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 … up to speed with electronic provider payments. So, Sanjog. Let’s start with this. What are the top trends you’re seeing today regarding digital payments and how have things shifted since the … payment vendor that integrates seamlessly with your payment integrity system, all you have to do is adjust and approve a particular bill, and it just gets paid. So, that creates a lot more …
Virtual Event

Workers' Compensation Technology, Blockchain and the Amazon Effect [Podcast]

… What changes do you see coming to workers' compensation, especially in the age of automation? … Data: Now that we have it, what do we do with it? … says that because the standards in workers' compensation are so high, figuring out what to do with the industry data has been a bit slower than in other industries. When applying certain …
Article

Kids’ Chance: Why it Matters

… the door. I'm greeting customers. I'm selling 50/50s. We're providing raffles. Whatever we can do to really provide more awareness, fundraising, and help them promote what it is in providing … the scope of the program. They're aware of Kids' Chance, but not so much what it is that they do, what their mission is in providing these scholarships, and all the different fundraising …
Article

Automate the Chaos: AI, Dashboards, and the Future of Claims

… can go in and see what are the bills that are waiting to be approved and processed and how do they relate to the injury?  We talked about the blue man visualization of the body parts. … Yeah, it's about surfacing insights. We do that at a claim level, but we also do that at the macro level, looking across those trends. Well, Jim, how do you use data to manage … So one of the things that my team, a huge component of what we do is conducting and performing annual and quarterly partnership meetings with our customers …
Podcast

Managing the Labor Challenge: Technology Solutions

… meet labor demands, younger, less-experienced professionals are entering the field. But, how do we bring these newbies up to speed so they can make the best decisions? Rebecca Morgan, Vice … Adjusters are staying in jobs an average of one to two years, and a lot of that has to do with the Great Resignation. We saw much higher rates of turnover through the Great … tech. In fact, they expect to use technology to perform their job functions. So, what problems do we expect to be able to solve with technology? Well, a couple of them. Training and retraining …
CE Webinar

Pain Management: Pharmacologic Alternatives to Opioids

… when and where it makes sense for that patient. We have a lot of different things that we can do to help patients address pain, so whether or not to use an opioid becomes a careful balancing … pain relief response where other opiate analgesics would, I think again it just has so much to do with individual patient variability and what works best for them.    … Q:If we have cut down the amounts of opioids prescribed then why do we still use 80% worldwide. …
Article

The More Workers’ Comp Gets High-Tech, the Better for Providers and Patients

… and other clinical workers. Given this high-stress backdrop, anything technology can do to ease the load on clinicians is a benefit. That’s why it’s welcome news that we’re now … today, according to NCCI. And the better this technology gets, the easier it is for workers to do their jobs while facing a lower risk of injury. When workers do get hurt at work, despite employers’ efforts to prevent injuries, technology has an important …
Blog

How QA Can Make or Break Your IME

… you have a robust QA process which builds trust with clients, and it shows them that not only do we understand the different lines of business, we also adhere to regulatory or policy requirements. I think one of the things that we do for each client which is really very important is we develop a client‑specific protocol, and we do that in conjunction with our QA team, our operations team, and the client. And that allows us …
Article

Ask The Pharmacist: Exploring Drug Market Exclusivity and Generic Availability

… When do drugs become generic? When drugs are first introduced, they are made available as brand name … a generic may be available, reach out to us at AskThePharmacist@enlyte.com  and our team will do the research and gather the information needed to best answer your questions. This information … with your 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

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

… So what are CTOs 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 do not have unlimited security budgets. Here’s a statistic to get you thinking about what to do: in 2015, the responsibility for more than 40 percent of all data breaches that contained … with them by sharing best practices and key learnings. In fact, we are currently looking to do this is through our newly formed Technology Advisory Council, a roundtable where CTOs and CIOs …
Article

Will We See Human Interaction Disappear with AI in Insurance?

… I would be challenged to explore all the potential use cases for it in a single blog post, I do want to take a look at how it is changing the way consumers interact with their insurance … to set in. Fortunately, AI provides a couple of new ways for consumers to connect that do not require an app—chatbots and voice-first interfaces. While we’re more connected than ever, … to set in. Fortunately, AI provides a couple of new ways for consumers to connect that do not require an app—chatbots and voice-first interfaces. First, let’s take a look at chatbots. …
Podcast

Exploring Use of GenAI in P&C

… Do they come with a general idea of how they’d like to incorporate the technology in their claims … release that they’ve read, or they can come up with ideas of technical things that you could do with it, right? Like, "Oh, I could summarize this, or I could have a chatbot that does that," … And to continue on that theme, Mike Cwynar, what other challenges do claims industry professionals face in better understanding and implementing this technology? …
Article

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

… a third of U.S. employees strongly agree that they have the materials and equipment needed to do their work properly, according to Gallup. Doubling the number of employees using the latest … the programs within your company that align with those key factors when talking to candidates. Do you offer a development program? How about grassroots empowerment groups? Community service … talking to new candidates. Help candidates understand the importance of the work they will do in the insurance industry. Spell out for them that what they’ll do will have a long and …
White Paper

Worksite Crisis Response

… have to be physically injured to suffer a mental blow. In workers’ compensation, we often do a great job caring for the physical injuries, especially those that are commonplace. But what happens following the less-common yet more severe incidents? Do we adequately care for or even acknowledge those unfortunate individuals who witness a …
Podcast

What to Look for When Choosing a Provider Network

… understanding what is happening in that market, in supporting better communication. So, how do we proactively identify provider issues before they become bigger problems? And, all of that … seeing in our own data, or that a provider may be feeling when they’re treating patients. How do we support our high‑volume providers, that require more of a higher touch? Organizations are … tools. So, provider offices are going to want to make sure that they have the ability to do things through self‑service. How do we validate, or how can they validate information with a …
Blog

Not all victims of workplace trauma sustain physical injuries

… and offers encouragement to accelerate recovery. Doing so is not only the right thing to do, but it can also prevent losses to productivity at both an individual and organizational … a time like this. I will contact you if we need further assistance. Thanks again for all you do.” …
White Paper

Networks 2.0

… prioritize both efficacy and efficiency. The best clinicians can more easily rise to the top of the stack thanks to deeper insights into patient trajectories. In the emerging scenarios, … algorithms pull data to evaluate outcomes and push data to aid clinicians in doing what they do best — taking care of patients in supporting their return to work and a return to their daily …