Article

Using an Advanced Medical Bill Review Platform to Improve Third Party Outcomes

… Some auto casualty insurance carriers’ workflows are missing a key part of an  end-to-end third party solution  – an advanced medical bill review platform. Though bill review is traditionally thought of as a specifically first party or workers’ compensation solution , it can also make an impact … to have the right tools to be able to easily explain these rules in negotiations. Because of these market trends, it’s difficult for an adjuster to negotiate using traditional adjustments …
Article

Secrets to a Successful Stay At Work Program

… Linda, to start off could you briefly describe the concept of a stay at work program? … A stay at work program is when employers have a program in which they will accommodate an employee’s needs based on restrictions and limits where an accommodation is needed in order … so the employee would not lift over 10 pounds within the essential job functions. This type of accommodation also prevents a disability claim. So, if an employee can remain productive at …
Article

Secrets to a Successful Stay At Work Program

… Linda, to start off could you briefly describe the concept of a stay at work program? … A stay at work program is when employers have a program in which they will accommodate an employee’s needs based on restrictions and limits where an accommodation is needed in order … so the employee would not lift over 10 pounds within the essential job functions. This type of accommodation also prevents a disability claim. So, if an employee can remain productive at …
Article

StateWatch Winter 2015

… will reject claims dated Oct. 1 or later that don’t contain a valid code from the 10th edition of the International Statistical Classification of Diseases and Related Health Problems, better known as ICD-10. This includes codes from ICD-9, … medication-assisted treatment and death benefits to surviving family members. The American Medical Association (AMA) is requesting more doctors use prescription drug-monitoring …
Article

The Heart of the Challenge: The Role of Direction of Care in Managing Workers' Compensation Costs

… At the core of the drug pricing challenges in workers' compensation is the concept of "direction of care." This refers to the ability of employers or payers to direct injured … employee can usually choose any pharmacy within the designated network. This contrasts with an "employee choice" model, where the injured employee has the freedom to select their own …
Article

Current Used Vehicle Market Conditions: Q2 2020

… produced monthly by Tom Kontos, Chief Economist, KAR Global. KAR Global is a leading provider of wholesale used vehicle auctions and ancillary remarketing services. 1 … and dealer demand, albeit by selling a more restricted quantity and higher average quality of vehicle. These conditions have continued into July. … According to KAR Global Analytical Services’ monthly analysis of wholesale used vehicle prices by vehicle model class, wholesale prices in June averaged …
News Release

Mitchell and Car ADAS Solutions Team Up to Provide Enhanced Calibration Support

… —Mitchell, a leading provider of technology, connectivity and information solutions to the Property & Casualty (P&C) claims and Collision Repair industries, and Car ADAS Solutions , an ADAS technology and services company, have joined forces to offer enhanced support for dynamic … Solutions' onsite evaluation, training, implementation, and support services can help North American collision repair facilities reduce cycle time and generate additional revenue by opening …
News Release

Puerto Rico Governor Declares State of Emergency

… In the aftermath of a 6.4 magnitude earthquake that struck Puerto Rico in the early morning hours of January 7, 2020, Governor Wanda Vazquez Garced has declared a state of emergency. Seismic … in how injured workers can access care, and Mitchell Pharmacy Solutions has been configured to account for these changes. The emergency declaration will allow impacted injured workers to fill …
White Paper

Taking Charge of Pharmacy with Proven Cost Containment Strategies

… Pharmacy costs are climbing and so are the risks of doing nothing. … not just inflated spend, but compliance issues and potential fraud. In today’s environment of increasing complexity and accountability, cost containment isn’t optional—it’s essential. …
Case Study

A Brighter Day

… patient satisfaction surveys from employees who she supports during the disability period of their care management. Below is an example of how Ms. Carilli makes a difference by serving as an advocate for injured workers.   … that she was significantly depressed and anxious over her health condition and spent most of the day crying. Her primary care provider (PCP) had prescribed an anti-depressant and …
Article

OEM Efforts to Promote Environmental Stewardship

… According to the Environmental Protection Agency (EPA), transportation contributes 27% of all greenhouse gas emissions in the United States. 1 Much of this pollution comes as a result … emissions in addition to other hydrocarbons and particulate matter. With the potential for an increase in Corporate Average Fuel Economy (CAFE) requirements looming on the horizon, … by 59% and waste production by 79.6%. 8 BMW has continued to focus on the production and purchase of energy from renewable sources and has also taken steps to improve energy efficiency …
Article

The Power of an Optimized Workflow: Automation, Customization and Solution Integration

… In order to achieve a fully optimized workflow, claims organizations should consider a variety of factors, starting with the three areas listed below.   Watch Video … The amount of time it takes for a claim to be triaged can have a lasting impact on the outcome of a claim. … this is to specialize teams based on claim type, location or other factors. Traditionally, an adjuster could be assigned a low-dollar claim, a catastrophic case and a claim with attorney …
Article

Current Used Vehicle Market Conditions: Q3 2018

… Tom Kontos, Executive Vice-President, ADESA Analytical Services. ADESA is a leading provider of wholesale used vehicle auctions and ancillary remarketing services. As part of the KAR Auction Services family, ADESA works in collaboration with its sister company, … Auctions, a leading salvage auto auction company, to provide insights, trends and highlights of the entire automotive auction industry. fleet/lease sales of three-my-old units w/36-45k miles …
Case Study

Getting It Right Makes All the Difference

… for Genex the past five years, Dianna Zellerman has mastered the ability to overcome one of the biggest challenges a non-field case manager faces in working with injured employees: … A 47-year-old paraprofessional slipped and fell on an icy pavement, injuring her right foot. While X-rays showed no evidence of fracture or dislocation, the woman still experienced severe pain. She was placed on stringent …
Article

Predictive Power: How AI Is Helping Workers' Comp Insurers Stay Ahead of Demographic Shifts

… adopt innovative strategies. In 2025, employees under 25 and over 55 now comprise nearly 40% of the labor market . This dual trend—an influx of employees newer to physically demanding roles alongside experienced employees extending their … Mental health challenges affect 20% of American adults annually, with only one-third seeking help. During the 2025 legislative sessions, … With 74% of Americans living in states where marijuana is legal in some form, insurers face a patchwork of …
Article

Current Used Vehicle Market Conditions: Q2 2024

… to fall into mid-June, as the less-than-impressive 2024 Spring/tax season market came to an early close. Nevertheless, wholesale and retail used vehicle market conditions are amenable to a less dramatic ongoing decline in prices than seen last year , as much of the correction to historical patterns of depreciation, seasonality and price-spread versus new vehicles has already taken place. … Market Trends The following graph and table summarize ADESA US Analytical Services’ analysis of NADA and Motor Intelligence data, respectively, on retail used vehicle and certified pre-owned …
Blog

COVID-19-Related State Budget Shortfalls and Resulting Impacts to Workers’ Comp

… impacts associated with COVID-19 have been far-reaching and headline-grabbing: “Record levels of unemployment”, “Shuttered businesses”, “Idled and furloughed workers”. Economists have struggled to predict “What’s next?” (both short and long-term) amid an ever-shifting backdrop of varying virus case numbers, differing public policy/governmental responses, and unsettled … economic impacts associated with COVID-19 vary due to many unpredictable factors. Loss of state and local revenue from taxes and rising expenditures associated with COVID-19 are …
Article

The Power of Perspective: Seeing the Full Picture of a Claim

… Every decision matters when handling an auto casualty or workers’ compensation claim. A poor decision could cause a delay in helping … for their injuries sooner rather than later. Having a comprehensive perspective into all of the events and details surrounding a claim is powerful—since good data often provide … Data are the most valuable to insurers when they use technology to help sort through all of the information to surface the insights that can then be automatically applied to the claims …
Article

Workers' Compensation Glossary of Terms and Definitions

… or want a refresher on common industry terms? Download our Workers' Compensation Glossary of Terms to learn the definitions of terms such as prior authorization and pharmacy benefit management. Learn more about workers' compensation with our Workers' Compensation Glossary of Terms: Download Now … Here is a preview of some of the main terms you’ll learn about in this workers’ compensation glossary: American …
Blog

What is an MCO?

… More often than not clients will ask the question: What is an MCO?  Well isn’t that a loaded question?  If we take it at face value, a Managed Care … Organization (MCO) is an organization that manages care.  Like Coventry, who manages all types of “care” injured workers seek to get on the road to recovery.  However, usually the question has … commonly referred to as MCOs.  From there it gets clear as mud.  While the general category of state certified programs may be commonly referred to as MCOs, when you get into the state …
Article

Current Used Vehicle Market Conditions: Q4 2020

… produced monthly by Tom Kontos, Chief Economist, KAR Global. KAR Global is a leading provider of wholesale used vehicle auctions and ancillary remarketing services. 1 … According to KAR Global Analytical Services’ monthly analysis of wholesale used vehicle prices by vehicle model class, wholesale prices in December averaged … Analysis is based on over seven million annual sales transactions from over 250 of the largest U.S. wholesale auto auctions, including those of ADESA as well as other auction …
Blog

A Look at the Foundation of Work Comp Pharmacy Trends

… trends we have identified in our 2017 annual Drug Trends Series and to dig into some of the key drivers behind these trends. The first drug trends installment reviews key trends and … and mail-order pharmacy view. Over the years, PBMs have exclusively focused on this subset of prescriptions for reporting their impact on the client experience through discounts in pricing per script as well as point-of-sale edits for utilization management prior to the prescription being dispensed. That’s …
Article

StateWatch Spring 2016

… toward primary care providers treating patients with chronic pain not related to cancer or end-of-life care. According to a March study by the … physician-dispensing workarounds are washing reform savings away . A practice by physicians of dispensing unusual dosages of repackaged drugs to avoid price controls has spread from California and Illinois into Florida … said. The study demonstrates that cost-shifting forces employers to pay more not only because of high fees for services, but through a greater number of claims and associated indemnity …
Article

The Great Workplace Shakeup: Adapting Workers' Comp for the Remote Revolution

… The growing trend of remote and hybrid work models has introduced new regulatory challenges to be addressed for the … 2021, according to analysis from the Harvard Business Review , this mass exodus was not simply an anomaly driven by the pandemic. Rather, it resulted from the convergence of five key factors that are reshaping today’s workforce—retirement, relocation, reconsideration, …
Article

Current Used Vehicle Market Conditions: Q2 2019

… Tom Kontos, Executive Vice-President, ADESA Analytical Services. ADESA is a leading provider of wholesale used vehicle auctions and ancillary remarketing services. As part of the KAR Auction Services family, ADESA works in collaboration with its sister company, … Auctions, a leading salvage auto auction company, to provide insights, trends and highlights of the entire automotive auction industry. wholesale used vehicle price trends …
Article

Current Used Vehicle Market Conditions: Q1 2019

… Tom Kontos, Executive Vice-President, ADESA Analytical Services. ADESA is a leading provider of wholesale used vehicle auctions and ancillary remarketing services. As part of the KAR Auction Services family, ADESA works in collaboration with its sister company, … Auctions, a leading salvage auto auction company, to provide insights, trends and highlights of the entire automotive auction industry. wholesale used vehicle price trends …
Article

Third Party Litigation Funding: A Symptom of Deeper Issues in the Legal System

… In the world of civil litigation, a new player has emerged—third-party litigation funders. These deep-pocketed … costs. While third-party litigation funding is a relatively new phenomenon, it is a symptom of deeper issues within the legal system that have been brewing for decades. Historically, the … fee arrangements, where attorneys receive a percentage of any settlement or award, has created an incentive for lawyers to pursue high-value cases. Third-party funding provides a way for law …
News Release

Mitchell Named Official Technology Provider of the Vale Paintless Dent Repair (PDR) Technician Certification Program

… Mitchell, a leading provider of technology, connectivity and information solutions to the Property & Casualty (P&C) claims and … coverage and hardware—will help technicians quickly and accurately assess damage, complete an appraisal and perform the necessary repair work. “Mitchell looks forward to supporting PDR Testing and Certification and the next-generation of Vale-Certified PDR Technicians,” said Jack Rozint, vice president of repair sales at Mitchell. …