Article

Progressive Pathways: Exploring Workers’ Comp Legislation in Texas, New York, Illinois, California and Tennessee

… Enlyte brings together decades of unmatched experience and industry expertise to examine the impact of current legislation and trends.  Enlyte has seen a 12% increase in our Workers’ Compensation … compensation claims. Michele shared that “Between Q1 2017 and Q2 2023, New York demonstrated an 11% increase in charge per unit, while Florida has seen a 7% increase, California a 9% … Whether it's the increase in potential fines and penalties in Tennessee, the relaunch of the Certified Provider Program, or ongoing discussions in Florida, each change brings new …
Article

Ask The Pharmacist: Bird Flu and Its Growing Impact on Public Health

… How serious is the threat of bird flu in North America?  Bird flu, or avian influenza, is an emerging public health and industry concern across North America. While the virus primarily … important questions around occupational exposure and public health safety. The Current State of Bird Flu in North America Since early 2022, the highly pathogenic avian influenza (HPAI) … on poultry farms, including restricted access, disinfection procedures and proper disposal of potentially contaminated materials. …
Article

Diagnostics Systems Key to Proper and Safe Repairs for Fountain Valley Body Shop

… shop over 40 years ago, owner Dave March has had a front row seat witnessing the evolution of the collision repair industry. In 1974 when his shop opened, only one automobile manufacturer … years away from crash-testing popular cars to encourage manufacturers to improve the safety of their vehicles. 1 When I have these vehicles come in as technical as they do, I really need a … make ‘em like they used to,” now translates to “you can’t repair ‘em like you used to.” In an age where damage is no longer a predictor of specific necessary repairs, it’s vital that …
News Release

Louisiana Amends Medical Marijuana Law, Exempts Reimbursement for Workplace Injuries

… In the final days of the Louisiana 2018 Regular Session of the legislature, lawmakers passed HB579, making amendments to their medical marijuana law. The … pain, which says in part, "It is pain so chronic and severe as to otherwise warrant an opiate prescription." Of particular importance to the workers' compensation industry is a …
Case Study

Breaking Down Barriers

… is a bilingual Integrated Disability Case Manager (IDCM) assigned to a major manufacturer of building and remodeling supplies. She employs her cultural expertise in managing her cases and … Four plant employees attempting to free up a plug in a line were sprayed with 25 gallons of asphalt after the tank opened up. The men were rushed to the hospital where they were … As the point of contact, Diaz served as the liaison for the employees, employer and TPA, communicating all …
Article

Celebrating Nurses Week: 7 Days Isn't Enough

… National Nurses Week — Happy 197th birthday, Florence Nightingale — I feel the familiar pang of disappointment. Why is it that we relegate just one week to honor the backbone of our health care system? To me, it’s an injustice, but I don’t hear many nurses complaining. Self-recognition is never the driving …
Article

StateWatch: Bill Review December 2018 / January 2019

… (HCPCS) Physician’s Fee Schedule and RVU files Home Health Seven states are in the process of updating to the International Association of Industrial Accident Boards and Commissions Electronic Data Interchange (EDI) Claims Standards. … to U.S. jurisdictions. EDI Claims Release 3.1 is the most current release and is maintained on an ongoing basis. Below is the schedule of states updating to 3.1: Oklahoma, September 2018 …
Article

StateWatch: Bill Review December 2018 / January 2019

… (HCPCS) Physician’s Fee Schedule and RVU files Home Health Seven states are in the process of updating to the International Association of Industrial Accident Boards and Commissions Electronic Data Interchange (EDI) Claims Standards. … to U.S. jurisdictions. EDI Claims Release 3.1 is the most current release and is maintained on an ongoing basis. Below is the schedule of states updating to 3.1: Oklahoma, September 2018 …
Conference

Guidewire Connections 2018

… support and maintain. However, well-built integrations can significantly improve the function of core business systems and, by extension, improve the outcome of claims handling. Bill Morgan, Guidewire and … the benefits that can be achieved by improving those integrations. Click here to read an article from Rebecca and Bill for a preview of the presentation. … Mitchell is proud to be a gold sponsor of this conference and will have a dynamic exhibit in the Partner Pavilion. Visit our booth to …
Conference

America's Claims Executive Leadership Forum & Expo

…  brings together professionals from across the Property & Casualty industry and all parts of the claims process. Join Mitchell for multiple events at this year's conference, including … a returning gold sponsor for this year's conference. Swing by the booth to discuss a variety of topics and trends with Mitchell experts, including: Auto casualty and workers’ compensation … Solution Workshop—The Power of Technology: How to Improve Casualty Claim Outcomes …
Blog

What is Legal/Liability Nurse Review?

… a Liability Nurse Review, they are one in the same. Since Coventry specializes in three types of reviews, those are the ones that will be covered in this article. … Scope of Service … Legal/Liability Nurse Review Full scope review including chronology, summary of medical history, recommendations and negotiation points Chronology Review Narrative timeline of medical events Consultation Customized to respond to a specific question or educational need …
News Release

Genex receives 2018 Communicator Award for "Robocop: The Jeremy Romero Story"

… WAYNE, PA - May 16, 2018 - Genex Services has been named a 2018 Communicator Award of Distinction winner in the category of Branded Content: Documentary for " The Rise of a Real-Life Robocop: The Jeremy Romero Story. " … to Genex's case management intervention which allowed him to walk again with the assistance of an exoskeleton device. The Communicator Awards are judged and overseen by the Academy of …
Blog

Legal Nurse Review Explained

… to mitigate the claim. To develop a defense strategy the Legal Nurse may employ any or all of the following activities:     …   Ultimately, the choice of which service to use depends on how you wish to use the information. Legal Nurses testify as … translation of complex medical issues into layman’s terms. While both services are billed at an hourly rate nurse review is less costly with a greater level of detail. Physicians may testify …
News Release

Mitchell Holds Annual mPower Customer Conference

… Mitchell, a leading provider of technology, connectivity and information solutions to the Property & Casualty (P&C) claims and … from major insurance companies and original equipment manufacturers (OEMs). The impact of intelligent automation, vehicle complexity and proper and safe repairs, and customer … In his keynote speech, “Business in the Age of Automation,” Mitchell President and CEO, Alex Sun, explored how exponential advancements in …
News Release

New York State Workers' Compensation Board Provides Updates on Prior Authorization Requests

… Any requests that are not handled in the appropriate time frame are subject to review and an Order of the Chair to mitigate the delay. Administrators using the portal should ensure that the proper … from the states' workers' compensation and auto insurance regulators. We will keep you advised of changes impacting the provision of pharmacy care in these areas. To review our 50-state guide …
Article

Long-Term Catastrophic Assessments

… Catastrophic injuries often require life-long medical care and a myriad of supportive services for injured employees. Depending upon life expectancy and injury severity, catastrophic claims can cost millions of dollars over an individual’s lifetime. Periodic comprehensive medical assessments are considered a best …
News Release

New York State Workers’ Compensation Board Proposes Pharmacy Rule Change

… 440.8 (c) dealing with pharmacy notification. The new language requires payers to notify out-of-network pharmacies or pharmacy processing agents when a claimant is subject to a pharmacy … when one has been established. The proposed language also requires payers to reimburse out-of-network pharmacies at the fee schedule rate until the pharmacy has been notified the claimant is subject to an established pharmacy network. Notice should be provided in the same manner that the …
Podcast

Peter Rousmaniere Part 1: Comp’s Evolutions and Influencers

…   When you think of industry icons in workers’ comp, Peter Rousmaniere is among the select few at the top of the list. For more than 30 years, Peter has been a major influencer in workers’ comp, … '80s, workers' comp premiums were going up about 15 percent a year, and there was a great deal of crisis in the employer community. I joined a two-person firm, Lynch Ryan. We built it into … the firm and to the business is that solving work injury problems at the workplace is a model of how to manage your workforce well. A company that manages safety and injury response well is a …
Article

Keeping Injectable Spend in Check with Smarter Utilization Review

… consistent and defensible. UR’s growing role in injectable oversight The increased frequency of injectables brings increased financial impact and a strong need for consistent clinical … may be driven by treatment mix, fee schedules or utilization controls. The combination of high utilization, high cost, and high variation is where UR brings clear value: not as a blunt … Clinically administered injections still dominate spending (WCRI cites 85% of injectable payments in early 2024), but self-administered injectables are taking a growing …
Virtual Event

Tips to Better Manage Your Glass Business

… In this webinar, Mitchell experts explore the impact of ADAS on glass repair and replacement as well as introduce the latest glass industry trends and … Watch Now Watch Now Glass has become a core component of proper, safe vehicle repair. According to Mitchell data, the average number of labor hours … In the U.S., there is at least one ADAS feature on 92.7% of new vehicles. Additionally, when an ADAS-equipped automobile is involved in a collision, precise calibration of the sensors— …
Article

Stop Reserve Drift Before It Becomes a Surprise

… gives you a grounded forecast of future needs so you can set reserves with confidence and steer the file with fewer surprises. What a medical cost projection does for an adjuster Medical cost projections are designed to support accurate reserve setting. They address future needs for a defined segment of time or lifetime expectancy. This is what it can include: Future medical Pharmacy Durable …
Article

Bone-Connected Prosthetics: What Adjusters Should Know About Osseointegration

… poor fit, and limited mobility. Osseointegration offers a different approach. Instead of relying on soft tissue, it uses a metal implant inserted directly into the bone. Once the implant heals and integrates with the bone, an external connector allows the prosthesis to attach directly to the skeleton. The result? A … and fit-related setbacks Higher prosthetic use and improved functional outcomes Lower risk of abandonment or prolonged disability  Today’s osseointegration techniques are safer and more …
Article

Managing Michigan Auto No-Fault Claims with Confidence

… Real-time review using nationally recognized medical treatment criteria as part of each client’s approved UR plan Automatic pend/review of bills based on customizable business rules Clinically sound recommendations backed by clear … review, enabling faster processing and response times  The results speak for themselves: an appeal rate of just 4% and average billing adjustments ranging from $537 to $1,375 per review. …
Podcast

Examining WCRI Study on Networks Impact on Claims

… Medical costs remain one of the largest drivers of claim expenses, and recent research from WCRI gives us a clearer picture of how networks are influencing not just costs, but access, care patterns and outcomes. To take a … : Sure, Tom. Thanks. You know, one of the most important takeaways in this study and the way that networks have evolved over time is that networks deliver measurable value across a number of different metrics across claim performance. So, for example, the study showed that networks …
Blog

3 Takeaways from WCRI

… annual conference delivered valuable research and insight on the current (and future) state of the industry. In today’s Inside Workers’ Comp, Genex’s Jim Harris shares three big takeaways … :  Jim, so it shouldn’t come as a surprise that opioids were one of the hot topics at this year’s conference, but did any of the new information surprise you? … : Absolutely it did. Dr. Alan Krueger of Princeton opened up the conference and he shared some pretty alarming statistics about opioid …
Article

Learn About The Auto Casualty Medical Price Index in 2017

… The National CPI for All Services, as reported by the Bureau of Labor Statistics in August 2017 is 120.9, which reflects a 1.7 percent decrease since Q1 2017. For the same period of time, Q1 2017 to Q2 2017, the National Auto Casualty MPI decreased 0.76 percent and as of … the emergency room remained nearly unchanged reflecting the first period since Q3 2016 without an increase. In Q2 2017, professional services in the emergency room experienced a 0.17 percent …
Article

Taking a look at blue light

… Approximately one-third of all visible light is “high-energy visible” or “blue” light. The original source is the sun, of … shows. Many school-aged children are still in virtual classrooms too, at least part time. On top of all that, TVs are getting bigger and brighter, as are the screens of tablets and phones. … - Set your phone display to block blue light or automatically adjust to ambient light - Use an e-reader like a Nook or Kindle that has a tinted screen to shield your eyes during extended …
Article

Texas Farm Bureau Insurance Puts Customer Service in the Driver’s Seat with Improved Workflow Processing

… a handshake. Texas Farm Bureau has thrived by emphasizing high-touch, personalized service as an operational hallmark, inspiring many customers to traditionally hand down their memberships to … visits and making schedule changes on-the-fly, creating workflow bottlenecks. “We are one of the few insurance companies left that have true multi-line adjusters in the field handling … meeting regularly with Mitchell to review data and fine-tune processes. Within a few weeks of our joint collaboration, our team began implementing changes and we quickly saw improvements. …