Article

Empowering Excellence: How Our Dedicated Team Elevates Care for Injured Employees

… the referral and order fulfillment process with overall efficiency throughout the lifecycle of an order. As far as platforms working seamlessly with each other, I believe Enlyte is at the … Specialty Solutions offer a one-stop-shop experience to make sure those recovering from an injury get what they need, when they need it.    Contact Us Today …
Article

Navigating the CARES Act Emergency Small Business Funding

… business owners in all U.S. states, Washington D.C. and territories are eligible to apply for an Economic Injury Disaster Loan (EIDL) . This loan will provide economic relief to businesses … the deferral period. EIDL Other programs offered through SBA.gov serve those who already have an SBA loan. If you have SBA funding, contact your lender. If you need local assistance with any … Business Enterprises (MBEs) with funding Lendio PPP Loans —taking applications for PPP Top 100 SBA Lenders —Zenefits offers a list of the top 100 SBA lenders and if they are processing …
Blog

Overview of the 2020 Texas Department of Insurance Workers’ Compensation Network Report Card

… reach 18-months maturity, the gap between Network and Non-Network costs expands further to an 8.4% differential. Claim mix and volume may account for variances in medical cost results between networks. Networks successful in reducing … maturity, costs within a Network setting are typically lower than Non-Network. This may be an indicator that Network utilization decreases, as the claim ages. In support of this theory, …
Article

Workers’ Comp Data: Healthcare Industry Sector is the Source of the Majority of COVID-19 Claims

… first few months of the COVID-19 pandemic, the workers’ compensation industry has gone through an unprecedented number of changes, from an increase in telemedicine to a shift to working from home. To get a clearer picture of how the … that have become essential during the pandemic—healthcare, trucking, warehousing—have seen an increase in workers’ compensation claims throughout the pandemic, while most others have seen …
Podcast

Examining Opioid Utilization Drug Trends

… morphine‑equivalent dose unless otherwise indicated. I find it helpful to talk about this in an analogy using currency to help people understand or explain that concept of MED. If you think … Medical literature and clinical studies have shown that there is an increased risk of death from opioids associated with rising morphine‑equivalent dose or MED. … Those metrics are important because lowering MED also helps to lower the risk associated with an opioid’s potential to cause life‑threatening respiratory depression. …
Article

Impact of Drug Formularies on Workers' Compensation State Laws

… discussions, it is important to understand what a drug formulary is and the role it plays in an injured worker’s recovery. … At the most basic level, a formulary aims to ensure that the medications prescribed for an injured worker are appropriate for the injury that the worker sustained. The California RAND … manifests as restricting the prescription of drugs that may prevent or deter the recovery of an injured worker. For instance, as the Pennsylvania legislature addressed, opioid …
News Release

Purdue Pharma and DOJ Reach Opioid Settlement
Article

Addressing Physician Dispensed Medications with Price Opportunist Drug Strategies

… were paid to physician-dispensers than to pharmacies.” Physician dispensing has long been an area of concern for workers’ compensation, first because it may circumvent some of the …   PTLA products can be significantly more expensive than their therapeutic alternatives. An example of this is Terocin® topical pain relief lotion. This drug consists of lidocaine 2.5%, methyl salicylate 25%, capsaicin 0.025% and menthol 10%, and has an AWP of approximately $400. However, the ingredients of this drug can be purchased separately …
Article

Decoding Functional Restoration Programs: Ensuring Accurate Billing Practices

… workers' compensation claimants get back to work. Just as a meal is made up of various dishes, an FRP includes multiple services tailored to each individual's unique needs based on their … tempted to use a single, non-specific CPT code (97799) to bill for all services provided under an FRP program, this approach is akin to a restaurant charging a single price for everything on the menu, regardless of what the customer actually ordered. Instead of providing an itemized bill, the provider would simply give the patient a single, lump-sum charge. This …
Article

Advanced Technologies Reduce Complexity and Restore Lives

… it’s also helping insurers as they go about the business of restoring people’s lives after an accident or injury. … that number could rise as high as 200 sensors. Technology helps make our cars safer, but when an accident does occur, it also makes our cars significantly more complex and difficult to repair. Simply put, the U.S. Department of Labor states that in 1965, an automotive repair technician needed to understand more than 5,000 pages of service manuals to …
Article

Information is the Key to Proper & Safe Vehicle Repair

… This ruling may well have represented a watershed moment for our industry and presented an opportunity for every party in the collision repair ecosystem—OEM, insurance company, … with our customers and Mitchell Advisory Council members, I know proper and safe repairs are top of mind. And as a general manager of an organization that serves as an active participant in this ecosystem, the role we all play …
Blog

Examining High-Impact Drug Class Trends

… are being prescribed in workers’ comp with growing frequency — ranking third among the top therapeutic classes at 12.4 percent of total drug cost and representing 5.7 percent of total … concerns regarding cost management. Breaking out our data from 2021 a little further, the top five topical medications in our book by cost were represented by four prescription topicals … volume within the category. Interestingly, Voltaren Gel is available both as a generic and as an over‑the‑counter product, following the FDA’s approval for the OTC product launch in February …
Article

Specialty Solutions Spotlight: What Adjusters Need to Know About Foot and Ankle Injuries in Workers’ Comp

… diagnostics, transportation and other services, call us today at 877.203.9899 or send an email to apricus.referrals@enlyte.com .    …
Article

Motor Vehicle Markets: Q2 2017
Article

Mind Over Matter: Addressing Mental Health Comorbidity With Pharmaceutical Treatment

… and that up to 85% of patients with chronic pain are affected by severe depression.” In an auto accident, rates of depression post-injury can be particularly prevalent. A study in the … is reduced, inflammation is also reduced —leading to healing. Secondly, the mind can have an impact on the intensity of the symptoms a person feels. In an interesting study using virtual reality gaming, burn injury pain was reduced by up to 50% more …
Blog

Overview of the 2019 Texas Department of Insurance Workers’ Compensation Network Report Card

… over $12K per claim 1 .  Texas was leading the nation in utilization for nine of the ten top diagnostic groups. Return-to-work rates were running in the low 60 th percentile and injured … maturity, costs within a network setting are typically lower than non-network. This may be an indicator that utilization decreases, as the claim ages when network providers are managing … rate than those not enrolled in a network. In 2019, 94% of injured employees enrolled in an HCN reported returning to work after their injury, compared to 90% for non-network injured …
Article

Workers’ Comp Data: About 25% of COVID-19 Claims Have Associated Medical Costs

… COVID-19 Comp Claims This graph shows the top industries contributing to workers’ compensation claims in 2020, comparing claim volume … compared to any other sector throughout the pandemic, it makes sense that this industry saw an increase in the number of claims reported. Same with transportation and warehousing, as online … Public Administration). **The Transportation and Warehousing sector, while not one of the top contributors to claim volume, also experienced a 24% increase in claim volume in 2020.   …
Article

The Evolution of Claims Automation

… capabilities, insurance carriers are on a quest for the Holy Grail: touchless estimates. Why? An automated appraisal process is expected to deliver: Improved Efficiency and Appraiser … approach may work for field estimating, but a scalable, automated appraisal solution requires an open, flexible and cloud-based ecosystem that can easily integrate with other critical … technologies that continually reduce the reliance on human effort as they build out an automated claims experience. …
Article

Workers' Compensation Pharmacy Legislative and Regulatory End of Year Recap

… compensation pharmacy programs. For pharmacy benefit management (PBM) roles, staying on top of these changes is critical for compliance and operational efficiency. Below is a recap of … one public hearing.  The new rule, filed with the Secretary of State on December 19, 2024, has an effective date of July 1, 2025, granting employers and providers a little more than a … Enlyte will work with you to utilize this time to determine an appropriate administrative fee and align your processes with the updated fee schedule to …
Blog

Managing Catastrophic Cases: Best RTW Strategies for the Worst Workplace Injuries

… and then there's going to be supervisors and management that are involved. There's going to be an interruption in their daily operations. They need to have that position functioning in order … values on them, and it's really important for the employer and the carrier to be on top of them so they can be managing to their financial needs in the case. Another consideration … to reporting certain injuries to OSHA, for instance, within certain time frames. They need an evaluation of the injury and the long‑term impact that it's going to have in order to be …
Article

How Intelligent Automation Is Changing the Nature of Work in Insurance, Collision Repair, and Beyond

… idea is that if a person does a two-minute task thirty times a day, automating that task saves an hour of work a day, adding up to weeks over the course of a year. The potential savings … impossible to distinguish from a human, if not for the fact that it self-identifies as an automated service. You really must hear it for yourself , if you have not done so already. Imagine a world in which everyone has an artificially intelligent personal assistant. The implications for businesses are profound and …
Blog

How to Handle a Disaster in Workers’ Comp

… emergency contact information for the claimant is not readily available, usually because it's an after‑hours type of referral. Now, multiply this by 10, 50, or 100. I have seen mass casualty … on‑ and offsite so that at least two people have 24/7 access to employee records. We had an event where there was a granary explosion, and the HR records were all contained within the …
Article

Drug of the Month: Insights Into COVID-19 Vaccines and Workers' Comp

… and releases the spike protein, prompting host immune system recognition and mobilization of an immune response. The vaccinated individual is then protected from next encounters with the … 28 days apart, respectively) to provide targeted immunity. Both manufacturers are projecting an additional 100 million doses to deliver by the close of Quarter 1, 2021, and these are … targeted distribution, priority allocations and actual vaccinations is executed will be an important feature in stemming the spread of illness. …
Article

The Implications of Trump's Health Care Executive Order for Workers' Compensation and Auto Insurers

… payers can consider several strategies.  Enhancing risk assessment and pricing models to account for potential increases in drug costs and supply chain disruptions will be crucial. …
Article

New Hazards and Opportunities for Insurers in the Internet of Things

… of progress in the 21 st century—it will be more like 20,000 years of progress.” We are at an incredibly important moment in time—one that I believe historians will look back on as a … in the way humans interact with it. The world is quickly moving beyond the Age of Information, an incredibly fast-moving period marked by the rise of computing, home computers, the Internet, … the wheel on the road to behind the wheel at a workstation. Further, while he may have been an independent contractor before, a remote driver operating from a data center would most …
Article

Enlyte Compliance Insights: Navigating the Maze of Regulatory Compliance and Governmental Affairs

… While new challenges are inevitable, they also open new opportunities. Partnering with an organization with the right knowledge, involvement and forward-looking strategies will help …
Article

The Importance of Hospital Discharge Planning in Workers’ Compensation

… Hospital discharge planning is an integral part of the transition to a different facility or home. Without the appropriate care and support, numerous factors can complicate an injured employee’s recovery. A well-planned hospital discharge is vital in preventing … National Council on Compensation Insurance (NCCI) reported the frequency of claims has dropped an average of 3.9% per year while severity has increased. In addition, the NCCI notes that …
Article

The Importance of Hospital Discharge Planning in Workers’ Compensation

… Hospital discharge planning is an integral part of the transition to a different facility or home. Without the appropriate care and support, numerous factors can complicate an injured employee’s recovery. A well-planned hospital discharge is vital in preventing … National Council on Compensation Insurance (NCCI) reported the frequency of claims has dropped an average of 3.9% per year while severity has increased. In addition, the NCCI notes that …