Article

The Intelligence Report

… Q2 CASUALTY REPORT 2024 Read the first quarterly edition of The Intelligence Report, a series of publications featuring the newest capabilities Enlyte is bringing to the casualty market– … When adjusters go into negotiations it is extremely helpful to have representative data of payments made to providers from as many resources as possible to aid in the settlement … Enlyte's Industry-Wide Set of Benchmarks Includes:​ …
News Release

Oklahoma Adopts New Workers' Comp Fee Schedule

… The Oklahoma workers' compensation system saw a couple of significant changes over the past week. On May 18, 2020, Governor Kevin Stitt signed Senate Bill 1375 into law, adding chiropractors to the list of providers who can be reimbursed under the fee schedule. Governor Stitt also signed HJR1028 on … Oklahoma Workers' Compensation Commission and approved by the legislature. There were a number of updates across all specialties. Pharmacy reimbursement remained basically unchanged. However, …
Article

Premiums Written: Q1 2019 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, we were featured in PropertyCasualty360 … time to focus on the claimant. Below I’ve included a link to Nina’s article and a list of my other favorite articles from this quarter! … Humanizing the Insurance Claims Process: The Power of Integration and Automation …
White Paper

Workers’ comp networks are constantly evolving

… we see constructive partnerships between providers and payers that include a wide variety of provider types and a range of specialty services to serve injured workers. Next-generation networks are often tighter, … smaller — right-sized — networks that benefit all involved by grouping together the best of the best. Many such networks pull together smaller groups of providers with specific expertise …
Article

Property Casualty 360: Establishing a quality IME process for your workers' comp claims

… job. At the same time, you need to guard against inappropriate treatment or potential abuse of the system. In the PropertyCasualty360 article , "Establishing a Quality IME Process for your Workers' Comp Claims," Mike Valasek, president of Med-Eval, and Steffen Nelson, president of OMAC, both divisions of Genex Services, explain why insurers are moving toward best-in-class …
News Release

Genex Services Acquires Leading Case Management Firm M Hayes

… ), one of the nation's largest providers of managed care services, announced today that it has acquired M Hayes, a leading case management … and disability insurance markets. Financial terms were not disclosed. “Our acquisition of M Hayes underscores Genex's strong commitment to clinical services and the critical role they … employees and 47 service locations throughout North America.  The company serves 381 of the top Fortune 500 companies in the U.S. today. In addition, Genex is the only company that delivers …
News Release

Genex Introduces Unity—a Platform Powering Innovative Managed Care

… and streamline managed care operations. Its mobile application facilitates rapid delivery of case updates to appropriate parties. Unity enables payers and employers to refer and easily coordinate the services needed on each claim, accelerate delivery of those services, improve outcomes and enhance program performance. The system's overarching … care management insights, and event-driven workflow processing throughout the entire continuum of medical management services, including case management, independent medical examinations, …
Blog

More Money for More Kids!

… week allows Kids’ Chance and its partners, like Coventry, to highlight and raise awareness of this ever-growing organization that provides educational opportunities and scholarships for children affected by workplace injuries. Coventry is a proud supporter of Kids’ Chance of America and actively participates with many of the organization’s state chapters. About 18 …
Article

A chat about long COVID

… The Sounding Board recently met with Kate Farley-Agee, our Vice President of Network Products at Coventry, and Tammy Bradly, our Vice President of Clinical Product Development, to talk about the long-term effects that many people who … : Yes, definitely. In mid-2020 we saw a first wave of people who’d had COVID-19 and recovered, meaning they no longer had the virus, but many of them were not feeling “back to normal.” Some continued to feel fatigue, brain fog, headaches, …
News Release

FDA Approves Generic Lyrica Pregabalin

… Lyrica (pregabalin) is one of the most commonly prescribed drugs for neuropathic pain. The drug was first approved for use in 2004 and has since seen several patent extensions. Lyrica was the 15th top selling drug of 2018, with sales totaling $4.97 billion . On July 19, 2019, the FDA gave nine manufacturers …
News Release

Mitchell Announces Third Party Medicare Module Available in DecisionPoint Platform

… bill review platform, allowing carriers to automatically apply a percentage multiplier of the Medicare fee schedule to review medical bills within a third party claim. The new module … when negotiating settlements for third party claims while considering the unique aspects of each claim.     … Module is designed to be highly configurable, allowing each client to select the percentage of the Medicare fee schedule they want to use as their benchmark pricing and the specific …
Blog

Virtual Connections: Utilizing Technology to Build and Deepen Relationships with Injured Workers

… As the telemedicine industry continues to boom we’re seeing more and more new forms of telehealth emerge in the marketplace. Variations including tele-rehab, remote patient … even “avatar-like” nurses being utilized by hospital systems and providers. In this new world of telehealth we need to constantly be looking for innovative modes by which triage and … serve and engage them on their road to recovery. At Coventry we are piloting two new types of Virtual Connections designed to support our clinical staff in the establishment of trust and …
News Release

Marijuana Legalization Gains Ground

… The legalization of marijuana marched forward on Election Day, though it stubbed its toe in North Dakota. Voters … Proposition 2, which would legalize medical marijuana. However, prior to the vote, proponents of the measure and the state legislature worked out a compromise bill that will be passed during … in Congress, perhaps 2019 becomes the year when the federal government re-evaluates the status of marijuana as a controlled substance. It may be one bi-partisan issue on which a divided …
News Release

Genex Wins Communitas Award for Corporate Social Responsibility

… Genex Services, Inc. ("Genex"), the leading provider of case management services to the workers' compensation, disability, and auto markets, has announced that its Case Manager Scholarship Award Program is the recipient of a Communitas Award for Corporate Social Responsibility. Genex's annual program provides … are intended to recognize the Genex graduates from these schools, strengthen awareness of the case management profession, and invest in a new generation of future graduates to fill a …
Article

Enlyte Quarterly Medical Price Index - Q2

… As reported by the Bureau of Labor and Statistics (BLS) for April 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 2020 to include data from the period Q1 2020 through the end of Q4 2023 by coverage type. New for this report is our starting point, or anchor of 2020. In …
Article

What to Consider When Doctors Dispense in Work Comp

… On average 39% of pharmacy spend comes from non-network dispensing channels. With pharmacy costs rising managing … channels often bypass the traditional clinical and cost controls applied through point-of-sale systems. These transactions include third-party billers, clinics, physician offices, and … visits and may also include specialty and compounding pharmacies. These sources represent some of the typical charges received after the medication has already been delivered to the patient. …
Article

Stress Management: Doing Breathing Exercises

… include belly breathing and roll breathing. How do you do breathing exercises? There are lots of breathing exercises you can do to help relax. You might try … to learn and easy to do. After you have mastered belly breathing, you may want to try one of these more advanced breathing exercises. Try all three, and see which one works best for you: 4-7-8 belly breathing Morning breathing Roll breathing All of these exercises can help you relax and relieve stress. Belly breathing Lie on your back. You …
Article

5G: What High-Flying Predictions Mean for the Property & Casualty and Collision Repair Industries

… Today’s technology news is dominated by articles about the promise of 5G, and with 5G set to roll out even more broadly in 2020, the impact that it will have on the … phones information 600 times faster than today’s speeds. Further, 5G will enable connections of up to 1 million devices per square kilometer. That is significantly more than the 2,000 to … devices that respond seemingly instantly will bring about important innovations in a range of sectors, including the Property & Casualty and collision repair industries. As Kent Finley …
News Release

Mitchell’s Plan to Address Michigan SB1 No-Fault Legislation for Bill Review

… and Assessment Our first step will be to make sure we fully understand every aspect of the legislation inside and out. This piece of legislation is large, complex and ambiguous in many areas. In order to complete a full … and pose questions and options to our Regulatory Compliance Management team for identification of scope. Over the next 60 days, Mitchell will be mapping content from SB1 in our foundational …
Article

New York No-Fault Fee Schedule: What You Need to Know

… and significant changes to specific ground rules stating that providers may not bill outside of their section of the fee schedule. Find out what you need to know now to comply and what impact it may have for insurers and medical providers operating in the state of New York. … 34th amendment and 35th amendment to 11 NYCRR 68 (Insurance Regulation 83). To summarize, some of the updates include: 1. Physical Modalities The maximum recommended amount has been increased …
News Release

Genex Services Evolves Brand to Position for the Future

…  - Wayne, PA - Since pioneering the concept of medical management in workers' compensation in 1978, Genex has become one of the largest and most experienced medical cost containment and disability management providers today. As the industry has grown and changed, Genex has been at the forefront of delivering programs and services that incorporate meaningful data and analysis to address the … throughout North America. The company serves 381 of the Fortune 500 companies as well as the top workers' compensation and disability carriers and third-party administrators in the U.S.  In …
News Release

COVID-19 Update

… (COVID-19) outbreak, Mitchell is working diligently to ensure the health and safety of our employees while maintaining commitments to all of our customers and partners. Since the situation remains fluid, we will continue to update you … that the ability to service our clients and the safety and well-being of our employees are our top priorities. Our business leaders have implemented business continuity plans specific to …
White Paper

Modifications to Living Spaces Make Injured Employees Feel at Home

… was grievously injured at work, the last thing he might have expected he would need as part of his recovery was a real estate agent. But that’s exactly what the father of two required after falling from a second-story balcony on the job and becoming a paraplegic. … Bill’s situation also underscores how broad-based specialty networks that offer a range of services can meet the sometimes-extraordinary needs of those who get hurt on the job. Home …
Article

Modifications to Living Spaces Make Injured Workers Feel at Home

… was grievously injured at work, the last thing he might have expected he would need as part of his recovery was a real estate agent. But that’s exactly what the father of two required after falling from a second-story balcony on the job and becoming a paraplegic. … Bill’s situation also underscores how broad-based specialty networks that offer a range of services can meet the sometimes-extraordinary needs of those who get hurt on the job. Home …
CE Webinar

Medical Marijuana and Workers' Compensation

… is not available for previously recorded sessions. This program is a comprehensive review of case law and trends on the medicinal usage of marijuana. In 1972, the US Congress placed marijuana in Schedule I of the Controlled Substances Act because they considered it to have "no accepted medical use." …
Podcast

Why We’re Thankful for Workers’ Comp

… Thanksgiving is coming, which means it’s time for our favorite podcast of the year: What are You Thankful for in Workers’ Comp?  This year, we invited three experts who share very different reasons why they are grateful for comp: Heart of Case Management Award winner Charlene Ramsey, RN, BSN, CCM; Helen Froehlich, vice president of case management; and Donna Bradshaw, vice president of IME Services. We hope their responses …
Article

Enlyte Quarterly Medical Price Index - Q3

… As reported by the Bureau of Labor and Statistics (BLS) for October 2024, the consumer price index in the United States … after declining in the two previous months. The index for hospital services saw a decrease of 0.6% which follows a 0.6% increase in the previous month. The BLS index for physicians' … 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 …
Article

Care Management: Empowering Knowledge For Case Managers and Those They Serve

… appeared in  CareManagement , and is reprinted here with permission. Advocacy is the heart of case management practice. The Code of Professional Conduct for Case Managers from the Commission for Case Manager Certification … health, wellness and autonomy through advocacy, communication, education, identification of service resources, and service facilitation. Board-certified case managers are obliged to …