Article

New Medical Price Index Reports Coming in 2019

… 2018 was a big year for us. New technologies, more data and an expanded set of solutions—it is clear that a lot has changed. As our industry continues to … to re-envision our Medical Price Index reports to bring you an even higher level set of data solutions and expertise. For this reason, we will not be including the MPI data in the …
Article

Five Guidelines for Provider Data Management

… Click here to read the first article titled, “Why Provider Data Quality Matters.” The majority of healthcare provider data today is fraught with inaccurate or duplicate information, causing a multitude of issues for claims organizations, notably workflow inefficiencies and suboptimal outcomes. An accurate provider database can help to improve efficiencies, but managing provider information … 1. Create a Single Source of Truth for Provider Data …
News Release

Press Release - ECC Speaking Announcement

… "OPIOID USE: EXPLORATION OF ADDICTION" PANEL DISCUSSION  … Downers Grove, IL - March 17, 2017 - Coventry will participate in "Opioid Use: Exploration of Addiction," a panel discussion being held at the Eastern Claims Conference (ECC) April 2nd … are beginning to bear fruit in workers' compensation;  (3) The larger psycho-social context of chronic pain and the behavioral strategies that must be part of the solution.  The discussion …
White Paper

Value-Based Contracting

… to case rates, pay-for performance, risk-based payments, risk-reward, bundled payments, and an outcomes based payment model. To some degree, each is correct. Think of value-based contracting, or VBC, as a new name applied to several well-established concepts … not process or fee-for-service. Value-based contracts would be more appropriately thought of as an umbrella term rather than a single idea. And there are several critical components to …
Blog

Bringing value-based contracting to workers’ comp offers opportunities and challenges

… unfold in workers’ compensation remains less clear due to the industry environment. The intent of the value-based approach is to realign payment for health care services from the entrenched … services, and instead directs payments toward the results achieved by a treatment or episode of care. In short, it’s a way to get more bang for our proverbial buck. So, instead of having to … can be assured of collecting a simple, all-encompassing fee for seeing a patient through an episode of care. Value-based scenarios show up most often in realms such as specialty services …
Conference

2022 Enlyte Technology Executive Conference

… The Enlyte Technology Executive Conference (enlyteTEC) is an invite-only event featuring the most impactful innovations and insights from the experts at … for September 12–14, 2022 to enjoy exclusive content, leading industry insights and plenty of opportunities for networking during this in-person conference.   To be invited to this event, … technology and service focused main stage presentations and expert sessions, plus plenty of opportunities to connect and network during signature social events.   …
Article

Mitchell Collision Repair Industry Data: Q1 2018

… same period last year. Continued development suggests a final Q1 2018 average appraisal value of $3,196 Average Appraisal Values, ACVs and Age All APD Line of Coverages Comprehensive Losses In Q1 2018, the average initial gross appraisal value for … our servers was $3,062, compared to $3,048 in Q1 2017. Factoring for development produces an increase in the adjusted value to $3,103.   Average Appraisal Values, ACVs and Age …
Case Study

Starbucks Coffee Company

… Genex Services: A Key Service Provider in an Award-winning Strategy … guidance on self-care and help identify appropriate providers.” - Noreen Olson, Manager of Claims, Risk Management, Starbucks Coffee Company … the company recognizes as “partners” within its operations. Starbucks is known for creating an exceptional experience for customers, and its nine-member workers’ comp team took this … process, so claims could immediately be managed. The team also implemented direct deposit of indemnity payments, so partners wouldn’t have to worry about receiving paper checks and could …
Article

Mitchell Collision Repair Industry Data: Q2 2018

… period last year. The continued development suggests a final Q2 2018 average appraisal value of $3,140. title … our servers was $3,267, compared to $3,329 in Q2 2017. Factoring for development produces an increase in the adjusted value to $3,292. average appraisal values, and age comprehensive … periods. Factoring for development yields an anticipated Q2 2018 adjusted appraisal value of $2,981, a $93 increase in average severity over Q2 2017. average appraisal values, acvs and …
Article

Understanding SB1160: The New California Utilization Review Process

… up to its signature by California Governor, Jerry Brown, SB1160 gained a tremendous amount of attention from those in the California workers’ compensation industry. This bill, which was signed into law on Sept. 30, 2016, speaks to persistent delays and denials of medical care for injured workers, contains reforms that could considerably impact workers’ … 1, 2018, and shall retain active accreditation while providing utilization review service, by an independent, nonprofit organization to certify that the utilization review process meets …
News Release

Enlyte’s 2024 Trends Report Addresses Top Challenges in the P&C Industry

… current with prescription drug trends, and managing medical and auto claims costs amidst fears of inflation and legislative and regulatory changes. To help insurance and automotive leaders … delivers valuable insights from renowned subject matter experts at Enlyte, the parent company of Mitchell, Genex and Coventry. In an extensive report covering a wide array of today’s most pressing issues, industry leaders …
Article

Ask The Pharmacist: GLP-1 Drugs in Workers’ Compensation

… in increased costs for workers’ compensation claims due to longer recovery times and periods of missed work. According to From Day One , a Forum on Corporate Values, employees want weight-loss drugs offered through their employer health plans. With the development of stronger drugs like Ozempic (semaglutide) approved for type 1 diabetes, and the recent … Information Tirzepatide (Zepbound, Mounjaro) is a GLP-1/GIP-1 receptor agonist approved as an adjunct to diet and exercise in adults with a BMI of > /= 30 or > /= 27 with at least one …
Article

P&C Industry Claims Severity: Trends, Drivers and Mitigators

… Claim severity has always been top of mind for the P&C industry. While the pandemic has certainly had an impact on claims costs, there are several drivers behind claim severity trends varying by … While there seems to be increased costs in some areas, others vary depending on segmentation of industry groups . For example, while severity with essential workers is increasing due to the … affect a claim’s development,” Mariellen Blue and Jim Harris (Genex Services) explain in an article for Workers’ Compensation magazine on claim severity scoring. Preventative services, …
Article

How Managing Provider Data Can Make a Positive Impact on the Claims Process

… .” As we’ve established in the first two articles in this series, provider data quality is an issue in the Property & Casualty industry that can be challenging to manage and maintain. … making, which can in-turn lead to improved efficiencies and outcomes for claims organizations. An MIT study found that companies who engage in data-driven decisions improve outputs and productivity by 5 to 6 percent more than those who do not. Here are a few examples of how a claims organization can make provider data and analytics actionable to improve workflows …
Author

Keith Higdon

… Keith Higdon is President of Customer and Market Operations for Enlyte, where he leads the company’s customer and … solutions. A results-driven, customer-centric executive, Higdon brings more than 30 years of leadership experience across insurance, SaaS, and managed services organizations. He is widely … full P&L responsibility for one of the largest third-party claims administrators. Higdon is an active industry and academic contributor, having served as an advisor, mentor, and adjunct …
News Release

New York Workers' Compensation Board Releases Formulary Emergency Rule

… The New York Workers' Compensation Board released an emergency rule the week of November 4, 2019, making changes to some drugs associated with body … to a body part condition, but would be appropriate for treating a condition that arises out of the injury where use of the particular drug would be in accordance with prudent medical … The implementation of the drug formulary is less than 30 days away. Carriers and claims administrators should have …
News Release

FDA Authorizes Pfizer/BioNTech COVID-19 Vaccine for Emergency Use

… On December 11, 2020, the U.S. Food and Drug Administration (FDA) granted an emergency use authorization (EUA) for the first severe acute respiratory syndrome coronavirus … by Pfizer and a German firm, BioNTech. The EUA authorizes its use for the prevention of COVID-19 disease caused by SARS-CoV2 in individuals 16 years of age and older. This same vaccine, already authorized for use in five other nations (UK, …
Conference

Auto Glass Week 2017

… The Auto Glass Week 2017 conference features a dynamic group of speakers, panelists and keynotes, as well as an exhibition floor. Auto Glass Week takes place Wednesday, October 4, 2017 – Friday, October 6, … Mitchell is pleased to announce that John Gilmartin, Vice President of Service Operations will be speaking at an educational seminar to discuss why Mitchell National Auto Glass Specifications (NAGS) and list …
Article

Getting Started as a Work Comp Adjuster: Practical Tips and Advice

… As a new adjuster, you might find yourself dealing with an overwhelming volume of claims, handling extensive documentation and complying with constantly … these challenges with success.  Here are some tips to help you excel in the complex world of workers’ compensation. … with all parties involved, ensuring that you can manage your tasks effectively, regardless of your location. In addition, having access to a dedicated care coordinator as a single point of …
Podcast

Understanding ADA guidance for long COVID disability

… Recently, the Biden administration issued guidance on how long-term effects of COVID-19 could qualify as a disability under federal law. So, we asked Genex’s Kevin Ufier to … : There is guidance on that in EEOC documentation about long‑haulers. First of all, there’s the acute phase where people have symptoms like fatigue, shortness of breath, … Epstein‑Barr or chronic fatigue — issues we have seen for 20 to 30 years — with people having an acute phase of a disease and then there are lingering symptoms that impact functioning on a …
News Release

Genex Patient Satisfaction Survey Reveals Five Factors That Matter Most to Injured Employees

… across the country were disrupted by the COVID-19 pandemic, injured employees under the care of Genex case managers reported their highest patient satisfaction scores over a five-year … period. The 2020 Genex Field Case Management Patient Satisfaction survey revealed 96.4 percent of injured employees said Genex's field case managers positively impacted their recovery. "Genex has always prided ourselves on providing excellent coverage of case management services across the country, with professionals who have established …
Article

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

… For the past few years, the insurance industry has become increasingly concerned that many of its most experienced adjusters are thinking about retirement. As many of our most veteran employees are getting ready to walk out the door, the industry needs to not only find a way to retain all of their invaluable expertise, but also make changes to attract, train and retain more young … The insurance industry today has an experienced generation of adjusters, many of which have been in the industry their entire careers. While the data shows …
News Release

Empire State Legalizes Recreational Marijuana

… 31, 2021, New York Governor Andrew Cuomo signed S854 , a bill that would legalize the use of marijuana by adults 21 years of age or older. The bill, sponsored by Senator Liz Krueger, passed the Senate on Tuesday, was … employees being prescribed medical cannabis are afforded the same rights and protections an injured worker would enjoy under the workers' compensation law when prescribed medications …
Article

Is the Supply Chain Creating Critical Drug Shortages?

… cancer drugs. Currently, there are no medications on the list that represent a large volume of active prescriptions for workers’ compensation. Regardless, delayed access to maintenance drugs for additional chronic conditions can have an impact on injured worker treatment and recovery. An important point to note is that about 80 percent of active pharmaceutical ingredient manufacturers are located outside of the U.S. According to …
News Release

CEO Alex Sun Introduces Mitchell’s 2nd Quarter 2020 Industry Trends Report

… SAN DIEGO, CA—Mitchell International, a leading provider of technology, connectivity and information solutions to the property & casualty claims and … collision repair industries, today released its Industry Trends Report for the second quarter of 2020. The report presents current data, important trends, and valuable recommendations for an industry still managing the impacts of COVID-19 on employees, customers and business …
Conference

Enlyte to Exhibit at the 2026 NCIGF Annual Conference

… Enlyte is proud to participate as an exhibiting sponsor at the 2026 National Conference of Insurance Guaranty Funds (NCIGF) Annual … country to collaborate on issues impacting the property and casualty guaranty fund system. As an exhibiting sponsor, Enlyte looks forward to connecting with attendees to discuss how … The conference provides a valuable forum for peer exchange, policy discussion, and exploration of best practices that strengthen the guaranty fund system and protect policyholders.  If you are …
Article

StateWatch: Bill Review June/July 2018

… Department of Labor … Compensation Drug Formulary has been adopted for all workers’ compensation claims with a date of injury on or after July 1. This rule limits opioids to an initial 5-day supply and 50 morphine equivalent dose (MED) per day and subsequent prescriptions are not to exceed a 90-day supply. The list of approved medications can be accessed here. … Division of Workers’ Compensation … Division of Workers’ Compensation …
Article

StateWatch: Bill Review June/July 2018

… Department of Labor … Compensation Drug Formulary has been adopted for all workers’ compensation claims with a date of injury on or after July 1. This rule limits opioids to an initial 5-day supply and 50 morphine equivalent dose (MED) per day and subsequent prescriptions are not to exceed a 90-day supply. The list of approved medications can be accessed here. … Division of Workers’ Compensation … Division of Workers’ Compensation …