News Release

State-By-State Pharmacy Rule Updates Related to COVID-19

… In the wake of COVID-19, a number of states have begun relaxing time frames and other rules around the provision of care for their citizens, including injured workers. Almost every state has declared an emergency in an effort to secure their share of federal disaster relief funds related to the …
CE Webinar

Introduction to Prosthetics

… This session provides an overview of prosthetic design, components and technology. During the webinar we review different types of amputations, prognosis factors and complications along with the various stages of prosthetic …
Case Study

A Better Plan

… An experienced workers’ comp case manager who has developed strong relationships with the best … quickly coordinated the appointments with pain management and translation services. Because of her positive relationships with the local providers in the area, Meyer-Gaede was able to quickly assign the appointments with an interpreter present at every meeting. She identified the treatment time frames for the injury …
Article

Understanding Predictive Analytics For Workers' Compensation Data Analysis

… As technology evolves, several key ideas continue to permeate our conversations. One of the most exciting topics in 2018 is the application of predictive analytics in insurance and claims handling in particular. Unlike many of the … analytics has specific and practical workflow applications today and continues to be an industry game changer. … is a practice that analyzes historical facts in order to predict with a certain level of certainty either future events or outcomes. …
Blog

As robots come to work, our tasks will include safety and quality

… Robots are coming for your job. That’s the thrust of much of the discussion around automation and work. While that might one day prove true for many of us, … of course, without breaks, weekends, or holidays. It’s easy to see why managers would want an indefatigable, injury-proof dynamo capable of lifting heavy equipment or shuttling materials … there are other aspects to consider when it comes to robots. Cost is one because this type of high-end automation can be expensive. Of course, as with other technologies, prices have …
News Release

North Carolina Opioid Rule Goes into Effect May 1, 2018

… are specific to care being provided to injured workers in North Carolina. Here is a summary of the more critical points of the new guidelines. … Acute phase defined as 12 weeks of treatment following accident of injury or following aggravation of injury Chronic phase … the 12 week acute phase using a targeted medication Presumptive urine drug test means an initial urine drug test that identifies negative specimens and presumptive positive specimens, …
Article

Artificial Intelligence Gets Real: Three Ways AI Is Making Inroads in P&C Insurance Claims

… For many of us, artificial intelligence (AI) still seems like the stuff of science fiction, but in reality, we interact with AI everyday through devices like Amazon Echo … named AI a top strategic trend for 2017, and according to a recent study by … , 85 percent of insurance executives surveyed plan to invest significantly in artificial intelligence over the … outcomes for both claimant and insurance company. The insurance industry itself is at an inflection point in terms of AI. There are so many AI-related technologies, they are all in …
News Release

Genex Services Launches New Approach for Workers' Compensation Rx Safety

… Genex Services announced today the launch of … a customized and integrated approach to prescription drug management in workers' compensation. An enhancement to Genex's current PBM management program, Medication Safety 2.0 includes … said Ron Skrocki, vice president of product management and development for Genex Services, one of the nation's largest providers of workers' compensation managed care services. …
Blog

How QA Can Make or Break Your IME

… can make a big difference. In today’s Inside Workers’ Comp, Donna Bradshaw, vice president of IME services at Genex, explains why a strong quality assurance (QA) program is vital to any … helps meet your client’s needs and expectations. Each client may handle a different line of business — such as workers’ comp, auto, disability — and within each of those lines, there may be regulatory or policy requirements which must be followed and adhered …
Article

Quarterly Drug Update: Pharmacy Drug Spend

… CompPharma's 2018 Annual Survey of Prescription Drug Management in Workers' Comp found that, in the past eight years, drug spend has decreased 31.5% among those surveyed in workers’ compensation. Part of this is due to increased focus on dangerous opioid prescribing behaviors and the implementation of state-mandated formularies. Opioid spend has decreased for the same group by around 18.22% in …
Podcast

Using Remote Therapy Monitoring to Improve Compliance Costs in Comp

… : The rise of wearable technology has allowed physical therapists to monitor injured employees to gather … It is a hybrid or adjunct to traditional therapy models. A big part of physical therapy is always giving a home exercise program and hoping that the patient takes what they learn in the clinic to home, both in a formal home exercise program or just an activity modification. But over time, as technology’s improved, you’ve gotten these …
News Release

Enlyte’s Q2 Medical Price Index Shows Increases In Comp and Auto Injury Services

… 11% in workers’ comp and 5% in auto first-party over the past four years, despite a slowing of growth over the past two years, according to new data released by Enlyte today. Enlyte’s most … medical bills during that span. The Enlyte Medical Price Index data is representative of the top 200 procedures billed under each coverage for professional services. The report provides … include rises in utilization and inflation, Hibbert said. Enlyte’s data also revealed an interesting trend in New York in comparing auto first party and workers’ comp MPIs. The state …
Article

How COVID-19 is Impacting Prior Auth Rules in Comp

… The COVID-19 pandemic has dramatically changed the health and social landscape of our country, impacting injured workers and their treating providers from several vectors. Of immediate and increasing concern is access to medically necessary care for injured workers. In … and time frames for workers’ compensation claims handling. New York recently issued an emergency order , guiding stakeholders to conduct claim-handling activities remotely where …
News Release

Mitchell l Genex Acquires CompAlliance, Expanding and Enhancing Managed Care Services

… solutions, medical cost containment and disability management has announced its acquisition of CompAlliance, an established provider of managed care services, including its Preferred Provider Organization (PPO), Medical Bill …
News Release

Mitchell | Genex Acquires CompAlliance, Expanding and Enhancing Managed Care Services

… solutions, medical cost containment, and disability management has announced its acquisition of CompAlliance, an established provider of managed care services, including its Preferred Provider Organization (PPO), Medical Bill … accelerates property, casualty and disability claim processes through the broadest continuum of technology and services, best-in-class clinical and pharmacy solutions, an expansive range of …
News Release

Progressive Insurance® Extends Relationship with Mitchell Through Long-Term Contract Renewal

… — Mitchell , a leader of auto physical damage technology solutions, today announced that Progressive Insurance , the … the relationship and look forward to continued collaboration as we focus on meeting the needs of our customers.”  Progressive selected Mitchell as its primary auto physical damage technology … continuing to work together to support Progressive’s claims technology needs. About Mitchell, an Enlyte Company Mitchell International, Inc. is a leader in the development of innovative auto …
Article

Specialty Solutions Spotlight: Why Prosthetic Claims Are Among the Most Complex in Workers’ Compensation

… device fitting. These claims are about more than the device itself since they represent an injured employee’s path to regaining mobility and rebuilding their life. With the right … High upfront and ongoing costs for fitting, refitting, and replacement Varying levels of patient engagement and comfort with device use Multiple stakeholders—prosthetists, physicians, … options and participate in decisions are more likely to adapt successfully. Look for signs of engagement in provider reports and encourage communication that keeps the injured employee …
News Release

Battery Electric Vehicle Collision Claims Continue to Rise Despite Sales Slowdown

… —Mitchell, an Enlyte company and leading technology and information provider for the Property & Casualty … affecting claim costs and repair operations. “Although BEV sales have slowed in 2024, sales of mild and plug-in hybrid automobiles remain strong,” said Ryan Mandell, Mitchell’s director of claims performance. “Like BEVs, these vehicles can be costlier to repair after a collision … The total loss frequency of BEVs and 2021 and newer gasoline-powered vehicles—which are comparable in their complexity and …
News Release

ODG Updates Muscle Relaxant Formulary

… as “Y” and those that are not as “N” or not recommended as first line treatments for an illness or injury. States and payers that use the formulary may require prior authorization for any non-Y drug to define its medical necessity for an approved injury. The formulary is organized to allow ready evaluation of medications in a therapeutic category for their brand and generic names, generic and over-the- …
Article

Six Ways TCMs Are Crucial During COVID-19

… setting. This has become extremely important over the past few weeks with the challenges of social distancing. Treatment delays can lead to more complex claims and recovery regression … prevention protocols. While the pandemic is tenuous for everyone, the high-risk set have an added layer of concern — how best to protect themselves from illness. We’ve increased our telepresence usage … how best to protect themselves while attending provider appointments or carrying on activities of daily living. This includes offering guidance on how to best maintain social distance in …
Author

Saundra Knight

… As Director of Corporate Communications for Enlyte, Ms. Knight is an expert in mobile consumer behavior and the impact of emerging technology trends. For more than a decade she has developed market strategy for a …
Article

Ask The Pharmacist: Adult Vaccination and Its Role in Workplace Health

… overlooked, adult immunization status can significantly influence recovery timelines, risk of complications and workplace absence—factors that directly affect claim outcomes and return-to-work planning. Staying current with recommended adult vaccinations represents an essential aspect of preventive health care with important implications for overall well-being and workplace … and the MMR (measles, mumps, rubella) vaccine for adults born after 1957 without evidence of immunity. COVID-19 vaccination and recommended boosters have also become an essential part of …
Article

Five Inevitable Technologies That Will Transform the Claims Process

… have seen that vision—20 years may be a bit long to be making predictions with any real degree of certainty. But there’s no reason why we can’t look at the world around us and make some solid predictions for the next five to 10 years. In the world of workers’ compensation claims management there are a host of problems that will inevitably be … are available today, the only outstanding questions are when and how they will start to make an impact. Below, I’ve listed five predictions for how we might use these inevitable technologies …
Article

How Personalized Care Leads to Faster Recovery Times

… approach” have gained much attention within workers’ compensation—for good reason. Helping an injured employee on the road to recovery can be complicated and a “one-size- fits-all” … and meet injured employees where they are in their journey to recovery?” Social determinants of health (SDoH) are a big part of the answer as studies on this topic estimate that the health care one receives only impacts 10 …
Case Study

Raise a Hand

… industry. Ms. Price-Benham consistently exceeds all business expectations at Genex. Below is an example of how Ms. Price-Benham’s case management skills changed the life of a worker with a traumatic hand injury.   … the employer. Once on the case, she quickly scheduled the patient for an appointment with the top hand specialist in the area and secured a diagnosis of reflex sympathetic dystrophy (RSD). …
Blog

Exceeding Expectations…We Are All Consumers

… whether or not you believe this to be accurate, we can likely agree that always being aware of the customer experience holds true. With increased expectations for simple and worry-free … and claims management staff. Exceeding customer expectations by providing the highest level of customer service contributes to a competitive edge and business growth. In the workers’ … worker Cognitive Behavioral Therapy (CBT) techniques can also be critical to establishing an open relationship and helping to overcome an injured workers’ non-medical, psychosocial …
Case Study

Home Team Advantage

… clinical background, Martin’s life experiences have helped her better understand the demands of injured employees and relate to the challenges they face.   … A 53-year-old male sustained serious lower extremity injuries after a stack of pallets fell on him resulting in shinbone fractures on both legs. The man was rushed to the … facilities and coordinated his transfer to an acute rehab facility that would accept an out-of-state jurisdiction claim and the associated rates of reimbursement. She also coordinated the …
Blog

My Way, Right Now

… to go to a store for things like groceries, gifts, and general necessities. Now you can do all of this with your phone. Even calling it a phone is a bit misleading, since calling someone is … with a company, whether through their website, mobile app, or even over the phone, could cause an otherwise loyal customer to go to a competitor.  Each experience provided by a company is an … new business models, and assessing new and disruptive ideas across all industries. The pace of change is faster every day. It is our responsibility to our customers to identify and leverage …