Article

Michigan No-Fault Auto Fee Schedule Frequently Asked Questions

… services rendered on or after that date. As we approach the effective date, there are details of the fee schedule that are still unclear. In Mitchell’s most recent webinar about the new fee schedule, we collected a list of questions from carriers across the industry; below, you’ll find our responses to help you … includes webinars, videos and other resources that detail the history, overview and structure of the fee schedule. …
Article

Ask The Pharmacist: Emerging Opioid Overdose Reversal Medications

… What are the different types of opioid overdose reversal agents, and how do they compare? Opioids continue to represent a decreasing portion of overall workers’ comp scripts, with favorable trends being seen in markers such as dose and … analogy is to compare a rescue medication to a fire extinguisher: having one doesn’t imply an imminent fire threat but serves as a precautionary measure, with the hope that it remains …
Article

Settling Future Medical? Don’t Let Medicare Turn It Into a Reopen

… Then Medicare shows up late and turns a clean settlement into a messy one. That is the kind of surprise that lands back on your desk when you least need it. Federal rules make it clear that … When an MSA should be on your radar … Medicare review: Medicare beneficiary and total settlement over $25,000 Reasonable expectation of Medicare within 30 months and total settlement over $250,000 Important: Medicare’s interests …
Article

StateWatch: Bill Review May 2018

… In an effort to help alleviate the nation’s opioid epidemic, Bill S. 2456, also known as the … Comprehensive Addiction and Recovery Act (CARA 2.0) of 2018 … , was introduced in the Senate Feb. 27. The bill’s language builds on the original CARA of 2016, calling for increased funding authorization levels to better coincide with the recent … has announced an update of its list of providers who are authorized to treat injured workers under the workers’ …
Article

StateWatch: Bill Review May 2018

… In an effort to help alleviate the nation’s opioid epidemic, Bill S. 2456, also known as the … Comprehensive Addiction and Recovery Act (CARA 2.0) of 2018 … , was introduced in the Senate Feb. 27. The bill’s language builds on the original CARA of 2016, calling for increased funding authorization levels to better coincide with the recent … has announced an update of its list of providers who are authorized to treat injured workers under the workers’ …
Virtual Event

The Gig Economy and Workers' Compensation [Podcast]

… We sat down with Ira Goldstein, Executive Director of The Black Car Fund to learn more about their work insuring working drivers in New York, the changing nature of work and the impact of the growing "gig economy". Listen to the podcast to learn more. … with it more challenges and risks. Goldstein points out three major areas: With the rise of Uber, Lyft and other ride-share companies, there has been an increase of inexperienced …
Article

Audit, Audit, Audit: Why You Should Further Scrutinize Workers’ Compensation Bills

… overpaying on medical bills. Auditing – a crucial but often forgotten or under-executed part of the claims process – can help payors identify questionable billing practices and prevent … Auditing can take many shapes and forms but the essence of an audit is to review and verify that every line item is billed correctly and accurately. Since … Identifying Facility Type Many states have adopted fee schedules that factor in the type of facility where services were performed in determining the price for services rendered. For …
Article

Premiums Written: Q2 2018 Casualty Must-Reads

… 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, Mitchell was featured in … Workers’ Comp Billing Errors Could Be Costing Payors By ClaimsJournal.com ClaimsJournal wrote an article diving into Mitchell’s analysis of billing errors and how an auditing technology …
Article

Top Trends in the Auto Casualty Insurance Industry - Mitchell Experts Provide Insights

… regulations, more expensive medical costs and increasing accident severity. Here are some of the top trends Mitchell’s auto casualty experts are seeing in the market that are influencing the … The auto casualty industry has reached an unprecedented juncture of market factors and technology capabilities that is creating unique … An Increasing Need for Customization in a Regulated World … Claim workflows are interconnected from First Notice of Loss through settlement.  With that in mind, carriers are looking for smarter solutions that …
Article

Enlyte Quarterly Medical Price Index

… As reported by the Bureau of Labor and Statistics (BLS) in February 2024, the consumer price index in the United States … price index (MPI) specific to P&C claims. This information is based on our own observations of charges and trends from professional service medical bills. These observances are anchored in … on by the increase in fee schedule payments. Florida has seen a 7% increase, California an 8% increase and Texas a 3% increase.   chart Auto First-Party Medical Price Index at the …
News Release

Genex Services Becomes Ticket to Work Provider

… activity, nurturing our self-esteem, social connections, financial security, status and sense of identity. When the ability to work is taken away from us due to a debilitating injury or … physical and mental wellbeing. That's why Genex Services is proud to announce it has become an authorized provider of the Social Security Administration's Ticket to Work program. The initiative is designed to …
Article

North Carolina Utilization Rules for Opioid and Other Pharmacological Pain Management Treatment

… in “ acute phase ” Prescriptions in “ chronic phase” Requirement to “consider” prescribing an opioid antagonist in certain scenarios. Suggestions to “consider” non-pharmacological … – Treatment within 12 weeks of: a compensable injury, an aggravation of a compensable injury , or a surgery for a compensable injury (Note that there … – Treatment more than 12 weeks from the beginning of the last “acute phase .” …
Article

Technology Meets Empathy in Modern Telephonic Case Management

… (AI), and other technological advancements. But at its core remains the clinical expertise of the case manager who promotes advocacy for the injured employee and supports them in their … The Essence of Personalization in TCM …   Central to the success of early intervention is the clinical expertise and specialized training of case managers. Their profound understanding of medical nuances, coupled with a deep …
Article

What is Credentialing? Why Should I Care?

… According to the National Library of Medicine , credentialing simply is the process of assessing the academic qualifications and clinical practice history of a healthcare … network providers. This monitoring checks for both federal and state exclusions and sanctions. An adverse event may result in immediate network termination or review by Coventry’s Quality …
Case Study

A Higher Calling

… matter the situation. As Genex case manager Stephanie learned, this includes managing care for an unlikely victim of gun violence in the most unlikely setting for a shooting to occur.   … to the case soon after the incident, Stephanie closely managed the treatment and recovery of the bishop. She worked closely with the hospital staff to ensure he received timely and appropriate medical care. She also obtained all medical records, clarification of diagnosis and treatment plan so the adjuster and employer could be updated about projected …
Article

Long-Lasting Pandemic Trends That Might Surprise You

… much about the way we live and do business. It may come as a surprise, however, how long some of these changes may linger long after the worst of the pandemic is behind us. Even more interesting is how interconnected many facets of life and work are, and how things can have a ripple effect permeating through industries. From … connected with friends and family, but they also helped us get what we needed from the safety of our homes. With the touch of a button, you could have lunch, face masks, and a new car …
News Release

Colorado Adopts New Prior Authorization and Payment Timeframes

… The Colorado Division of Workers' Compensation recently revised Rule 16: Utilization Standards from the Workers' Compensation Rules of Procedure, which defines the standard to be used in implementing the Medical Treatment … to the prescribed treatment in writing. A complete prior authorization request must include an adequate description of the necessity for the treatment, identification of the appropriate MTG …
News Release

Mitchell International Acquires Medical Consultants Network

… Mitchell International , a leading provider of technology, connectivity and information solutions to the Property & Casualty (P&C) insurance … and Collision Repair industries, announced today that it has completed the acquisition of Medical Consultants Network (MCN)—one of the nation's largest providers of independent medical … innovative decision support and risk scores to aid in the identification of claims in which an IME or peer review may be appropriate. This strategic acquisition will give Mitchell and its …
News Release

PRIUM's Mark Pew Receives IAIABC Gompers Award

… Mark Pew, Senior Vice President of PRIUM, a division of Genex Services, has received one of the highest honors from the … International Association of Industrial Accident Boards and Commissions (IAIABC) … . As one of six esteemed IAIABC President's Awards, the Gompers Award is given to an industry leader who has advocated for the improvement of occupational health, safety, and … , was recognized for his efforts to manage the overutilization of prescription drugs and educate stakeholders about the need to focus on the injured worker. He …
Article

Michigan No-Fault Reform: How to Prepare for the Utilization Review Administrative Rules

… Michigan is in the midst of making significant changes to its auto insurance system, including allowing for new policy … to send certain bills through retrospective utilization review. On July 2, 2020, portions of Michigan’s no-fault reform regulations will go into effect, including the utilization review … As we approach the deadline, it’s important that carriers understand the state’s draft of the utilization review administrative rules, what implications the rules may have on their …
Article

Westfield Builds Deeper Connections with Innovative Solutions

… Before there were cars, electricity, and telephones, Westfield was serving customers. The group of hardworking farmers from Medina County, Ohio, that founded the company in 1848 had a strong sense of community. What initially began as a way to protect local businesses has grown into one of the … how Westfield would transform its business in 170 years, what has remained unchanged is an unwavering focus on relationships and a commitment to caring and respect for others. Outside …
News Release

Mitchell Congratulates 2018 mPower Award Winners

… Celebrating customers for delivering an excellent customer experience through business innovations … — Mitchell International , a leading provider of technology, connectivity and information solutions to the Property & Casualty (P&C) insurance … Property and Casualty Conference October 1-3, 2018 near Palm Springs, CA. During the gathering of experts in auto physical damage, auto casualty and workers' compensation insurance claims, …
Article

Self-service tools can bring savings for both payers and providers

… it? After all, making calls isn’t its primary purpose. It serves as a communication device, of course, though typically texting, email, and chat are how we choose to do that communicating. Need a product? Instead of asking family or friends for their opinions on brands or going to local stores to see what … Google or Amazon. Can you imagine if you had to call Amazon every time you wanted to place an order? Technology has provided much easier ways to communicate and get what we need. The same …
Case Study

From Tragedy to Triumph

… When Charlene Ramsey, RN, BSN, CCM, is assigned to a case, injured employees are getting one of the industry’s most experienced and exceptional case managers. Thirty years of case management has prepped Ramsey for taking on some of the most challenging catastrophic cases.   … the paramedic quickly attempted to save a dying coworker before attracting the attention of aerial rescue teams by using a flashlight. He was soon airlifted to a local trauma center, …
Article

Ask The Pharmacist: Anti-Seizure Medications for Pain Management in Workers’ Compensation

… including the potential for abuse and addiction. The shift away from opioids to the use of more non-opioid alternative medications for pain has likely been contributed to by increased prescriber and patient awareness of the nation's opioid epidemic , as well as, the risks surrounding this therapeutic class, … and salicylates (Aspirin ® ). These two categories are available in combination as well where an opioid is paired with a non-opioid analgesic to provide enhanced pain relief while allowing …
News Release

Genex Services Acquires CID Management

… Deal creates an industry-leading technology solution and utilization review program in workers' comp … — Genex Services, the nation's largest provider of workers' compensation clinical services, has announced its acquisition of Comprehensive … Financial terms were not disclosed. With this acquisition, Genex is positioned to deliver an industry-leading utilization review (UR) program, extending its existing UR capabilities to …
Article

Seven Technology Features in Utilization Review Software to Control Medical Costs

… recognize its value and prioritize it in states where UR is not required. As the frequency of utilization reviews increases, the medical management software you select can give you an edge in managing claims. The best platform for your program will capitalize on efficiencies and better coordinate the efforts of medical professionals on tight schedules. How? Advanced technology. Choosing the right … Automation of Workflows …
Article

Healthy Eating Even When You're Stressed

… or microwave dinners—may seem easy or convenient. And it's easy to skip a meal and then grab an unhealthy snack or eat too much later. Break the cycle Unhealthy choices can lead to a cycle … filled with tasty veggies. How would you feel then? Would you be happy that you're taking care of your health? Maybe you'd feel proud. Feeling good about your choices may help you feel a … you might also try to make healthy eating a little more convenient. You probably have lots of ideas. Here are a few to get you thinking: Keep healthy snacks with you in your car, at work, …