News Release

Mitchell | Genex | Coventry agrees to acquire QualCare

… has entered into a definitive agreement to acquire QualCare Alliance Networks Inc. (QANI), one of the largest managed care organizations serving the New Jersey, Pennsylvania and New York … network access, care management and workers' compensation services. QANI will become part of the Coventry organization, expanding its network footprint in that region. "Both Coventry and QANI have proud traditions of maintaining excellent provider networks," said Art Lynch, Coventry President. "Our …
News Release

Mitchell Adds Dynamic Advanced Driver-Assistance Systems (ADAS) Recalibrations within Mitchell Diagnostics

… Mitchell , a leading provider of technology, connectivity and information solutions to the Property & Casualty (P&C) claims and … Service Solutions, enabling Advanced Driver-Assistance Systems (ADAS) calibrations for dozens of popular vehicle models and expanding Mitchell's leadership in supporting proper and safe … such as a Lane Departure Warning System (LDWS), could potentially help prevent millions of crashes per year when properly used. Dynamic calibrations are often required following …
Author

Delphia B. Frisch

… Frisch is executive vice president and chief operating officer at Genex Services, a division of Enlyte, where she is responsible for field branch sales and operations personnel, as well as delivery of all company service lines across the broad spectrum of Genex’s managed care services. …
Virtual Event

Webinar: The Pareto Principle: Applying the 80/20 Rule to the Connected Claim in Workers’ Comp

… Successfully managing workers’ compensation claims requires a delicate balance of connectivity, expertise, and focus. Applying these key principles across your organization can help you to see the full picture of the claim to identify program improvement opportunities, understand data insights, and apply … out how to apply the 80/20 rule to workers' compensation claims processing using a balance of connectivity, expertise, and focus: Find out specific ways you can increase connectivity …
News Release

In a Hazy Election, Marijuana Is a Clear Winner

… Arizona voters approved their recreational marijuana ballot measure. The Arizona Department of Health will be tasked with laying out the ground rules for the program. Nearly 67% of voters in New Jersey voted to approve recreational marijuana in the Garden State. The state … Montana voters approved Initiatives 118 and 190. Initiative 118 raised the age for legal use of marijuana to 21 and Initiative 190 legalizes recreational marijuana. Down south in the …
Article

10 Things You Need To Know About California SB 1160

… This includes provisions to eliminate utilization review (UR) delays and inappropriate denials of care for injured workers, as well as prevent billions of dollars in WC billing fraud. Check out the 10 things you need to know about SB 1160 to stay ahead of the complex and evolving regulations Download today …
Author

Miriam Encarnacion

… Miriam Encarnacion is the senior director of compliance and has over 30 years of experience in regulatory compliance, medical billing & reimbursement, medical bill review in … and workers’ compensation bill review, Ms. Encarnacion’s diverse background supports a variety of products and services. …
Article

Elevating Work Comp Care Through Physical Medicine Innovation

… receive timely, effective care can be critical to recovery. We recently sat down with three of our Enlyte industry experts— Ted Smith , Dora Morris , and Kim Radcliffe —to discuss how a … medicine program can help deliver optimal results.  Question: What trends are you taking note of in the physical medicine space?  … The increasing importance of prompt access to care; injured employees need timely appointments with physical therapists to …
Author

Alex Sun

… Alex Sun is the chief executive officer of Enlyte, the parent brand of Mitchell, Genex and Coventry. With a vision for serving the broader claims technology needs … repair industries, Sun has led the company's expansion to achieve unparalleled breadth of technology, casualty solutions, connectivity, and information service offerings. …
Article

Risk & Insurance: Catastrophic Thinking Derails Injured Worker Recovery; Here's How to Manage It

… Delayed recovery is a challenge coming to the forefront of workers' comp. It's defined as a lack of anticipated functional recovery in a medically reasonable period of time. Recently, many organizations have been seeking new ways—whether through telephonic or …
Article

Auto Casualty Medical Price Index: Q1 2018

… The National Consumer Price Index, or CPI, for All Services, as reported by the Bureau of Labor Statistics in May 2018, was 124.14, which reflects a 0.6 percent increase since Q3 2017 and further eliminates the decrease experience seen in Q1 2017. For the same period of time, Q3 2017 to Q4 2017, the National Auto Casualty Medical Price Index, or MPI, decreased … Services increased 24.1 percent. The National Auto Casualty MPI decreased 1.37 percent and as of February 2018, sits at 118.2. Charges associated with physical medicine services remained …
Article

Workers' Compensation Medical Price Index: Q3 2017

… The National CPI for All Services, as reported by the Bureau of Labor Statistics, in November 2017, is 123.6, which reflects a 0.4 percent increase since Q2 2017. For the same period of time, Q2 2017 to Q3 2017, the National Workers’ Compensation MPI increased 2.3 percent and as of November 2017, sits at 113.03. Since Q1 2006, the MPI has increased 13.03 percent while the …
Case Study

Early Arrival to Function

… since earned licensure in three countries. She now calls the U.S. home and has nearly 25 years of case management experience under her belt. Working onsite for a major airline company, Fleming … soon manifested into a serious bacterial skin infection which did not respond to two rounds of oral antibiotics.   … and could have resulted in a negative outcome for the injured employee. Facing a lack of available in-network wound specialists to treat the injury, Fleming enlisted the assistance of …
Author

Kevin Ufier

… Kevin Ufier, MEd, CRC, is national director of managed disability for Enlyte where he’s responsible for the development, oversight and management of disability services for the Enlyte customer base, which includes long-term disability … carriers, third-party administrators and employer groups. Mr. Ufier has over 29 years of experience in the field of vocational rehabilitation with expertise in early intervention …
CE Webinar

Stay-at-Work/Return-to-Work Tools for Claims Handlers

… to facilitate stay-at-work/return-to-work and assist employers with implementing a culture of return to work. Claims professionals will learn the importance of timely SAW/RTW and effective methods of working with employers and providers to improving overall injured/ill employee outcomes …
CE Webinar

Medical Marijuana Highs & Lows: Work Comp Clinical and Regulatory Trends

… ramifications do these state regulations have on workers’ comp? Join us for our annual review of the current regulatory trends and a review of the clinical aspects of marijuana usage along with the potential implications for the work comp industry. …
Article

How Can You Ensure Your UR Vendor is the Hiring the Right Physicians?

… The success of a utilization review organization depends on the quality of its physician network. UR physicians impact all stakeholders on a workers' compensation claim when they render a determination of medical necessity. For this reason, it's important to know how your UR organization recruits …
Author

Sanjog Patel

… Sanjog Patel is the director of product management with the Casualty Solutions Group delivering smarter technology solutions for their Provider Products. Sanjog brings more than 11 years of business and product management expertise across a variety of markets and industries. Prior to joining Enlyte, Sanjog served in multiple roles in Management …
Article

The Artificial Intelligence Revolution

… policies that match their unique needs. But it's not just about the tech; it's about the peace of mind that comes from knowing you're protected with the utmost care and intelligence. The future of insurance technology is here, and it's powered by AI. We're excited to be part of this transformation – are you?     Back to Insights   Want to learn more from our experts? …
News Release

Hurricane Delta Aiming for Gulf Coast

… areas still recovering from Hurricane Sally. Alabama and Louisiana have declared states of emergency. The Alabama supplemental declaration ordered the evacuation of all persons without a hurricane pass—typically non-residents. The Mitchell team will be … protocols will allow claimants to obtain early refills on approved medications in advance of the storm and will allow for longer fills incase access to pharmacy care is disrupted by the …
Author

Ebonee Hunter-Goldsby

… as a program and process implementation and improvement leader. With over 12 years of experience in the workers’ comp industry, she leads a diverse team of experts, including trainers, data management specialists, financial, quality and business … to delivering exceptional service. Working closely with IT, Ebonee ensures the implementation of technology for efficient operational processes. …
Virtual Event

Pot Policies in Workers' Compensation and Auto Casualty [Webinar]

… marijuana legislation has been making headway in several states this year. In this webinar, VP of Government Affairs Brian Allen and Chief Clinical Officer Dr. Mitch Freeman discuss marijuana … are also  considering   possible tax revenue opportunities from the drug and  the influence of criminal justice reforms. Freeman points out how increased public acceptance is also a factor in states considering legalization. However, studies are still mixed on the benefits of marijuana. He cites concerns about health risks related to high potency THC, especially as …
Article

Workers' Compensation Medical Price Index: Q1 2018

… The National Consumer Price Index, or CPI, for All Services, as reported by the Bureau of Labor Statistics, in May 2018, was 124.14, which reflects a 0.6 percent increase since Q3 2017 … and further eliminates the decrease experienced in the Q1 2017 results. For the same period of time, Q3 2017 to Q4 2017, the National Workers’ Compensation Medical Price Index (MPI) … to 9.4 percent—significantly below the National CPI for All Services reported by the Bureau of Labor Statistics. Please recall that the physical medicine MPI is looking strictly at unit …
Article

Health Care Price Transparency: What Workers' Comp and Auto Insurers Need to Know

… regulators and other payers to make informed decisions around fee schedule development, out-of-network pricing strategies and standardized reporting. … may evolve rapidly. During a recent compliance-focused industry webinar, Michele Hibbert , SVP of Regulatory Compliance Management, emphasized the importance of staying vigilant about price transparency regulations, highlighting this as a key compliance …
Author

Jonathan Rowell, Pharm. D.

… worked as a pharmacy manager for a large pharmacy retail chain. Jonathan has over two years of experience within the workers' comp PBM industry having previously worked in long-term care, … Jonathan graduated with a Bachelor’s degree in Ecology & Evolutionary Biology and a Doctor of Pharmacy from the University of Arizona. …
Article

Property Casualty 360: Managing workers' comp claims for older workers

… Comp Claims for Older Workers," Chikita Mann, MSN, RN, CCM, addresses the unique challenges of handling workers' compensation claims for the aging workforce. She highlights that older employees often face longer recovery periods and a higher likelihood of complications due to age-related factors. Mann emphasizes the importance of early intervention, tailored return-to-work programs, and proactive communication to …
Article

WC Magazine: Putting Out Fires

… putting-fire In the aftermath of a mass casualty incident (MCI), the workers' compensation industry is reminded of the importance of preparation. To minimize exposure, it is vital for employers and carriers to proactively …
Article

WC Magazine: Putting Out Fires

… putting-fire In the aftermath of a mass casualty incident (MCI), the workers’ compensation industry is reminded of the importance of preparation. To minimize exposure, it is vital for employers and carriers to proactively …