Article

Topical Medications in Workers' Compensation and Auto Casualty

… This article is part of our ongoing Quarterly Drug Update series. View our last article on gabapentinoids . Topical medications are an important part of care in the workers’ compensation and auto casualty industries, providing … by 379%. The topical generic with the greatest price change increased by 2529%. Eight of the top 20 topical generic medications with the greatest increases in AWP also had an increase in the …
Podcast

Trends in Third Party Claims and How to Address Them

… So let’s get started. What are the top trends you are seeing today impacting third party claims organizations and how have things shifted since the beginning of the pandemic? … claims and, for that matter, the entire property and casualty industry as a whole. The first of these is the changing insurance workforce. … shift across insurance and many other fields to remote work. Prior to 2020 less than 10% of the professional workforce worked from home all or most of the time, and while some experts …
CE Webinar

Case Management: Building Trust Through Advocacy

… seminar is designed to assist claims handlers, employers and case managers in developing an understanding of the importance of establishing trust with injured employees. The instructor will describe the role of advocacy …
Podcast

Why Telephonic Case Management Is Not One-Size-Fits-All

… to other additional clinical services, but some programs have staff that manage parts of their program. So, the fun part about my job is just doing that needs assessment, uncovering … I think staffing definitely is a challenge that a lot of our customers have. Recently, we had one program where their medical director was out on … that’s involved to be able to just maintain that operation. So, knowing that Genex is an organization that has the bandwidth, the structure, and the support and resources is often why …
Article

Managing Third Party Auto Claim Trends During COVID-19

… Fewer cars on the road, increasing accident severity, an uncertain economy—these are just a few of the unprecedented challenges the auto insurance … the best method to adapt to this ever-changing situation. Let’s take a closer look at some of the trends the third party market has experienced in 2020 and the potential changes you can … Mitchell analyzed its third party bill review data to identify multiple trends through June of 2020 including claim activity, sites of service, injury types, treatments patterns and more. …
Article

Insurers Lead in AI Investment

… In a recent study of 13 different verticals, the insurance industry invested more on artificial intelligence (AI) than any other industry—on average, $124 million per company surveyed. 1 Of the 54 insurance companies that participated, about half were in North America, and about half were in the property and casualty industry. 2 While the greatest areas of investment were security and customer service, investments were made across multiple business …
Article

If Over-the-Counter Meds Are Prolonging Pain, What Does This Mean for Workers’ Comp?

… After an ankle sprain or back injury, most people riffle through their desk drawers or purses in search of a bottle of ibuprofen or aspirin. The common family of pain relievers known as NSAIDs (nonsteroidal …
Article

Case Management: Can Any Nurse Do it?

… Amidst an ongoing nursing shortage, workers' comp recruiters are tasked with finding nurses who can make the transition from clinic to case management. As Debbi Bromley, Genex Senior VP of Human Resources, explains, it’s a unique role for those who have the skills to manage cases … look for nurses that no longer are interested in clinical work, and, believe it or not, a lot of them don't even know that case management is an option. So, we have to find those nurses. We …
Author

Nate Raskin

… As Senior Manager of Analytics for Mitchell’s Auto Physical Damage division, Mr. Raskin is an expert in translating complex business analytics into strategic workflow visioning and SaaS solution design. He is a vocal advocated of simplifying data and making analytics accessible for everyday business leaders. …
Article

Ask The Pharmacist: Risk Assessment for Opioid Use Disorder (OUD)

… the first test ( AvertD ) that uses DNA in assessing whether certain individuals may have an elevated risk of developing opioid use disorder (OUD). The Diagnostic and Statistical Manual of Mental Disorders (DSM 5-TR) describes opioid use disorder as a problematic pattern of opioid …
Article

Home Health Cheat Sheet

… home health care require specialized expertise to provide a seamless and customized transition of care. Whether an individual requires simple or complex home health, Apricus leverages a strong national network of credentialed home health care providers to coordinate the appropriate level of care for each …
Podcast

Pulsing Recovery: Bone Growth Stimulation's Impact on Comp

… The goal of workers’ compensation is to help injured employees heal as quickly as possible, so they can … not just to their jobs, but their everyday lives. Today, Enlyte’s Nicole Usher, Sr. Director of Operations, Apricus, returns to talk about a DME device designed to do just that, the bone … surgeries. This is typically where normal bone healing is delayed or impaired for a multitude of reasons. … Are bone growth stimulators effective for all types of bone fractures or are they limited in some capacity? …
Blog

Putting the ‘longest year ever’ behind us and looking ahead

… Recently we sat down with a number of Coventry leaders and asked them what’s on their minds as we begin the new year. More than one … that the “longest year ever” was finally over. They also shared their concerns and those of our customers and colleagues, as well as what they anticipate in the months ahead. … and predicting costs. Many payers have seen a drop in workers’ comp claims since the start of the pandemic, with unemployment still over 6% and fewer claims among those still employed. …
Article

Using Telematics to Prevent Distracted Driving

… is on the rise. 3 Distracted driving can lead to both increased frequency and severity of claims . 4 People who use their phones at the wheel have twenty percent more insurance claims than others in the risk pool. “Distracted driving is more predictive of an eventual loss claim than virtually any other behavior, including speeding and braking,” … the past decade as has their rapid adoption. “At least one ADAS feature is available on 92.7% of new vehicles available in the U.S. as of May 2018,” claims AAA. 9 If available technology like …
News Release

Workers' Compensation Drug Formularies—Changes Afoot, Deadlines Loom

… was a busy time for state workers' compensation systems in the creation and implementation of drug formularies . As deadlines approach for certain states in 2020, here's what you need to … will apply to all prescription medications written on or after January 1, 2020, regardless of the date of injury. … Preparation over the last six months included: Working with injured workers with dates of injury prior to July 1, 2019, and receiving drugs that require prior authorization under the …
Article

Stop the Specialty Service Spiral

… find themselves dealing with unnecessary time drains and administrative headaches caused by an outdated, fragmented approach to coordinating specialty care that risks both … Single Point of Contact … With an average 1-hour turnaround from referral to care coordination, injured employees receive the … Advanced insights match patients with accurately skilled providers with the correct frequency of care, to save you unnecessary expenses. …
Podcast

Rigorous vs. Permissive Utilization Review: Beyond the ‘Rubber Stamp’

… We see some process designs that just take too long. I think that's not an intent, but that is sometimes a consequence of programs in terms of how they're designed. We see programs that don't have a high degree of clinical rigor in them. … One of the arguments against UR is that it slows the return‑to‑work process. What can payers do to … that in them, so that's one way to ensure that the process is not an inhibitor or a delayer of return‑to‑work. When you have decisions that require more clinical review, in order to ensure …
Author

Monica Declercq

… Monica Declercq is senior vice president of global business services, where she leads a global service operation supporting both auto casualty and workers’ compensation customers. Her deep knowledge of process optimization, workflow design, service delivery models and partner management have earned Mrs. Declercq her reputation as an engaging speaker and thought leader. …
News Release

App Helps Keep Work Environments Safe From COVID-19

… are looking for efficient ways to keep work environments safe from COVID-19. Optis, a division of the managed care provider Genex Services, has developed Safe2Work, an app-enabled, web-based health screening program designed to help stop the spread of workplace illness. Continue reading here. …
Podcast

Combatting New Jersey Auto Casualty Challenges

… When an auto injury occurs, insurers often face challenges in coordinating with multiple vendors to … issue, and offer solutions for handling it, is Ben Roberts, vice president, utilization review of Genex. Ben, welcome. … So, when we look at New Jersey and first-party auto claims, what are some of the major issues that those in the industry face? … first put into place versus how we manage them today, has changed a fair amount. And so, one of the big components of the Automobile Insurance Cost Reduction Act requires insurance carriers …
News Release

White House Issues Executive Order on Drug Pricing

… On September 13, 2020, President Trump signed an executive order intended to lower drug prices in the United States. This order is a follow up … the policy to Medicare Part D consumers as well. The order grants authority to the Department of Health and Human Services to negotiate drug pricing with manufacturers and would potentially … paid by other countries. It will begin with limited demonstration projects. Implementation of the executive order will require extensive rulemaking, but it is unclear if rules could be …
Author

Ted Smith

… Ted Smith is the senior vice president of national sales for Enlyte's Specialty Solutions. With more than 10 years of experience in the workers’ compensation industry, Ted is an expert on managing specialty services, including diagnostics, durable medical equipment (DME), …
News Release

Workerscompensation.com: Sikorsky Sees 'Dramatic Results' with Onsite RTW Program

… a Lockheed Martin Company, saw a 48 percent reduction in lost workdays within 9 months of implementing an onsite return-to-work program. “That's absolutely huge,” said Maria Bayne, president of Bayne Consulting. “I've never seen a program drop as fast as this one did.” Continue …
Podcast

Personalized Comp-the Starbucks Way

… ideas at the National Workers’ Comp and Disability Conference . Among those will be winners of the prestigious Teddy Awards for workers’ comp and disability management. On today’s Inside Workers’ Comp, we welcome Steve Legg, director of risk management, and Noreen Olson, manager of claims , who were instrumental in developing Starbucks’ Teddy Award winning workers’ … significant shift that we made was selecting a new TPA. And what we did and why we took some of the actions that we took was really around trying to figure out the best way to meet our …
White Paper

The Ultimate Guide to Case Management eBook

… At Genex, we've always been passionate about advancing the field of case management. Over the years, we've accumulated an extensive amount of knowledge, insights, and best practices. We're eager to pass that expertise on to …
Article

Managing Crisis Events at the Workplace

… Providing employees with the support they need following a crisis can reduce the likelihood of prolonged stress, anxiety and even post-traumatic stress disorder (PTSD) that can disrupt the workplace and affect employee morale and productivity, absence and overall quality of life. Key Strategies … —Educate your workforce on the signs and symptoms of PTSD: re-experiencing the traumatic event, avoidance, negative changes in beliefs and …
Author

Nicole Usher

… Nicole Usher has 17 years of experience in the workers’ comp industry and has held multiple leadership positions including roles in finance, quality, and operations. With a longstanding knowledge of quality service delivery, she instills these values within her team, partners, and clients. As an operational leader, Nicole promotes innovative ways to provide superior client experiences …
Virtual Event

2020 mPower Virtual Conference

… COVID-19 and the CDC’s recommended travel guidelines. In order to help ensure the safety of all involved, we have made the decision to shift our 2020 mPower Conference to a virtual … thoughts on significant strides in innovation, technology, service trends and the future-state of the industry. Beyond Mitchell | Genex executive leadership, you’ll also hear from an array of top experts who’ll share insights on surviving and thriving in the current landscape, as well as …