Article

Managing COVID Cases in Miami-Dade County Public Schools

… including its own police department. Over the past two years, risk manager Rosa Royo has faced an unprecedented challenge in ensuring the district’s officers who contract COVID receive swift …
Blog

Utilizing Health and Behavioral Coaching Tools to Promote Wellness & Injury Recovery

… are a leading health concern — and can pose challenges to recovery and return-to-work. When an injury does occur, it is important to understand how the injured workers’ comorbidities can …
News Release

New York Updates Workers' Comp Drug Formulary

… 4 added and these same drugs were added to the Phase B list. These changes were adopted under an emergency rulemaking and published in the State Register on March 18, 2020. Comments will be …
Author

Steve Laudermilch

… where he led claims predictive modeling and analytics engagements.  Laudermilch holds an MBA from Saint Joseph’s University, Philadelphia, and a BA in Economics from Ursinus College, …
Author

Deborah Robinson Stewart

… Deborah Robinson Stewart joined Genex in 2001 as an attorney in the Social Security Department. In her current role, she is responsible for the …
Author

Ron Skrocki

… services. As senior vice president of product management and development, Mr. Skrocki is an innovative trailblazer who is instrumental in developing analytics-driven, flexible medical …
CE Webinar

Traumatic Brain Injury (TBI)

… to the brain or its coverings, not of a degenerative nature. Such insult or damage may produce an altered state of consciousness and may result in a decrease of one or more of the following: …
Conference

IAIABC 105th Convention

… The International Association of Industrial Accident Boards and Commissions (IAIABC) is an association of workers’ compensation jurisdictional regulators and industry professionals that … Speaking Session: "Top 5 Technologies Likely to Impact Claims Management" …
Case Study

Medicare Set-Aside Government Case Study

…  He underwent a L4-5 micro-discectomy and decompression. After the surgery, the IW reported an 80-90% improvement continued to take Flexeril and Duexsis for residual pain. …
Article

Top 3 Retail and Mail Order Trends

… opioids. We don't like to see a huge use in our sustained release. We have, as I think it's an industry seeing this trend continue for reasons of the prescribers are becoming more educated … Another metric that we track really closely as an indicator of risk when it comes to opioids is morphine equivalent dose just, leveling out the … Yes. Well, overall, the top therapeutic classes had decreases in cost and utilization by claim. As we just saw the data …
Podcast

Peter Rousmaniere Part 2: Trends and Advice for Comp

… 20 times over the last 15 or 20 years case managers at Genex. And, what I get from them is an understanding of the story of the worker. We’re not really talking about a back injury, we’re … space, the first people I’d go to would be case managers. What I get from [case managers] is an understanding of the story of the worker. We’re not really talking about a back injury, we’re … of the environment, so much seems to be coming to a head right now. Let me give you an example, because we’re seeing this in workers’ comp, which is the introduction of artificial …
Article

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

… about and summaries of what's in this hundred-page document that contains medical records for an injured person, but it's highlighting those relative, those salient points and then also … surgery or things along that line as well allows both organizations to really stay on top of what's happening here.     … that don't need to be touched, predicting medical bills that don't need to be reviewed by an adjuster. Which bills won't benefit from a human touch that could happen, at the most basic …
Podcast

Managing the Seismic Shift from Inpatient to Outpatient Physical Medicine Services

… depending on your focus as a therapist, whether you’re going to be a home health therapist or an outpatient therapist, you’re having to shift your training. Home health therapists had always … walking to the toilet. Now, the actual mobility, range of motion and recovery protocols from an outpatient center is better. Another thing to consider is the economic impact. An outpatient procedure has been proven to save over $8,000 than doing it inpatient. Sometimes …
Article

Navigating the Complex Landscape of Utilization Review in Workers' Compensation

… : Offers an Independent Medical Review process, which provides an objective reevaluation of denied treatment requests by a third-party reviewer. … : Appeals can be made through an Independent Review Organization (IRO), which reassesses the treatment request independently of … These processes ensure that decisions are fair and based on medical necessity, providing an essential check on the UR process. Technological Advancements: State Portals Technological …
Article

Who Will Fill the Void? Recruiting Younger Workers’ Comp Professionals

… There’s an old adage that no one has childhood dreams of working in workers’ comp, that we sort of fall … : I think insurance has that image in general. I mean, you don't really hear, "I want to go be an actuary so that nobody'll want to talk to me at a cocktail party." … as we are right now. But I think the rest of the environment, too, I think there's more of an emphasis on really enjoying the time that you spend at work. Again, when I started working so …
Article

Understanding HCPCS Codes as a Work Comp Adjuster

… equipment and services. Evaluating HCPCS Codes Assessing the appropriateness of HCPCS codes is an important element for adjusters managing claim costs and quality. This process helps ensure … a clear view of service utilization, enabling better decision-making and resource allocation. Top 30 Specialty Solutions Items Here is a list of the top 30 specialty items that are typically billed using HCPCS codes: …
Article

Seven Technology Features to Look for in a Medical Management Software Solution

… skilled medical professionals on a tight timetable. In order to accomplish these goals, many top-performing organizations are turning to technology. As utilization review becomes more … basis. Real-time data can provide a huge advantage in handling claims appropriately. Often, an individual requesting a medical review can feel as though the carrier is denying requests more … the due date for issuing indemnity payments to injured workers. And while not all states have an established turnaround time for utilization review decisions, it is critical to have a ‘due …
Article

Liability and Injury Evaluations: Understanding the Two Types of Recommendation Models

… historic carrier data and models built based on a combination of statistical analysis and on an insurance carrier’s best practices. While both types of models are built with the same purpose … the skillsets of the highest performing adjusters to help empower the rest of the claims team, an insurance carrier sets themselves up for consistent and accurate claim evaluations, regardless … Typically, an organization needs seven or more adjusters and other experts to build a best practices …
Blog

Impact of Masks on the Deaf Community

… important thing to remember is that you should work together with the other person to create an accessible environment2. Disregarding a Deaf person by telling them “never mind” or “it … . They provide home additions and apps for the Deaf and Hard of Hearing. They even include an infographic PDF with information for friends and family on how to be an ally to those with hearing loss. 1https://www.hsdc.org/services/deaf-101/ …
Article

Five Initial Evaluation Issues That May Delay Return to Work

… This common phrase is especially true in establishing a positive relationship between an injured employee and the treating physician in a workers’ compensation case. A thorough … during that first encounter between patient and physician. This is especially true if an individual has a language barrier and needs an interpreter, but also, the complexity of medical terminology and jargon can cause a …
Article

Growth in Special Materials and Its Impact on Estimating

… the claims impact all of these new special materials are going to have on claims severity. And an equally interesting question is how will appraisers and body technicians address repairing … Due to ever-increasing CAFE and vehicle safety standards, the OEs are in an epic battle to create lighter yet safer cars. For the equivalent weight, aluminum crash energy … observation of corrosion resistance led Land Rover to utilize aluminum (actually Birmabright, an aluminum/magnesium alloy) as the primary metal for its body panels and has continued using …
News Release

Mitchell Reports a Lower Total Loss Rate for Electric Vehicles

… —Mitchell, an Enlyte company and leading technology and information provider for the  Property & Casualty … at Mitchell. “Our data simply does not support that conclusion. In fact, even though an EV’s lithium-ion battery significantly increases the likelihood of a total loss outcome, we do … from Q2 in claims volume for repairable EVs of 1.86% in the U.S. and 3.14% in Canada. The top North American regions for EV collisions—British Columbia, California and Quebec—saw …
Article

Medical Cost and Inflation Trends: WC, First & Third Party Auto Claims

… Medical Price Index - National Inflation Between Q1 2017 and Q3 2023, New York demonstrated an 11% increase in charge per unit, while Florida experienced a 7% increase, California a 9% … and Q2 2023, Georgia demonstrated a 22% increase in charge per unit, while Florida has seen an 11% increase, California a 15% increase and Texas a 12% increase. Medical Price Index - …
News Release

Mitchell Report Highlights Increase in Electric Vehicle Collision Claims

… —Mitchell, an Enlyte company and leading technology and information provider for the  Property & Casualty … of parts repaired increased to 90.76% and 12.68% respectively Refinish time is nearly an hour more than for ICE automobiles, adding to claim costs Models new to the market are now …
Article

Ask The Pharmacist: Traveling With a Controlled Substance Prescription Medication

… be left without any medication for the remainder of the month and may potentially have less of an issue getting a replacement or early refill. Controlled substances, unlike non-controlled … pharmacist. Do you have a workers’ compensation or auto related pharmacy question? Send us an email at  AskThePharmacist@enlyte.com . To read more Ask The Pharmacist articles, please …
News Release

Mitchell Accelerates Total Loss Settlements for Auto Insurers and Policyholders

… Mitchell, an Enlyte company and leading technology and information provider for the Property & Casualty … fit for settling total loss claims quickly while meeting our customers’ expectations for an efficient claims experience.” Through the integrated WorkCenter Total Loss and Claim Toolkit …
News Release

Beneva Selects Mitchell to Streamline Claims Management

… —Mitchell, an Enlyte company and leading technology and information provider for the Property & Casualty … Beneva meet the needs of its more than 3.5 million members and customers.  Beneva conducted an extensive review of its technology platforms before choosing Mitchell as its provider of … appraisers and auto body shops in just one week.  “We’re thrilled to support one of Canada’s top insurers and leading providers in Quebec,” said Debbie Day, executive vice president and …
News Release

Mitchell Introduces New Commercial Truck Estimating Solution

… —Mitchell, an Enlyte company and leading technology and information provider for the Property & Casualty … Mitchell also expanded its coverage of motorcycles, ATVs and RUVs, providing the market with an essential special lines appraisal platform. Mitchell Cloud Estimating TruckMax features …