Article

CMS Issues Electronic Payments Frequently Asked Questions and Answers Document

… been able to submit payments electronically via the MSPRP. CMS has emphasized that the use of the portal is an enhancement and not a requirement. Below are a few of the 17 most frequently asked questions … a demand letter? I would like to use the electronic payment option to make a payment with an account that’s in a corporate or trust’s name rather than my own. How do I do this? The demand I …
White Paper

Guide to Selecting an Electronic Payments Vendor

… processing a paper provider check can cost claims organizations $8 per check. Selecting an electronic payment vendor takes time and energy — resources your team might not have. That’s … to bill review integration and provider engagement — all the factors between you and an electronic payment vendor that can help you save up to 90% on provider payment costs. …
White Paper

Guide to Selecting an Electronic Payments Vendor

… processing a paper provider check can cost claims organizations $8 per check. Selecting an electronic payment vendor takes time and energy — resources your team might not have. That’s … to bill review integration and provider engagement — all the factors between you and an electronic payment vendor that can help you save up to 90% on provider payment costs.   …
Author

Michele Hibbert

… Michele Hibbert is senior vice president of regulatory compliance management for the Casualty Solutions Group. Michele’s responsibilities … workers' compensation industries. Michele is a Certified Clinical Coding Specialist (CCS-P), an Officer of Healthcare Compliance (OHCC) and a member of the American Health Information Management Association (AHIMA) and American Institute of Healthcare …
Virtual Event

Successfully Navigating Third Party Claims in the Wake of the Pandemic [Podcast]

… On this episode of Mitchell’s mPower podcast series, Product Management Director Chris Williamson joins our host, Shelley Callahan, senior director of product marketing for Mitchell Pharmacy Solutions. During this episode, you will learn more … current trends and challenges in the third party market, as well as successful strategies that top-performing claims organizations are incorporating. They will also discuss the third party …
News Release

Restoring Lives: 2021 Heart of Case Management Awards

… Winners of top case management award help injured employees move beyond tragedy and return to meaningful standards of living … manner. These skills were evident in the nominations received for the 6th annual Heart of Case Management Award, which was expanded this year to include hundreds of Coventry case managers as well. The seven winners selected truly represent the best of these … Click here to see a video of what it takes to manage some of the most critical workplace injuries. …
Article

StateWatch Summer 2017

… The Department of Labor suspended an … available to the public, in a move OSHA has said would “nudge” employers to focus on safety. An OSHA spokeswoman quoted in a   Washington Post   article the delay   was implemented to … 1. Surgery may not always be the best option according to a report that questions the value of arthroscopy and knee replacement for some common conditions.   Published   in the   BMJ   …
Article

StateWatch Summer 2017

… The Department of Labor suspended an … available to the public, in a move OSHA has said would “nudge” employers to focus on safety. An OSHA spokeswoman quoted in a   Washington Post   article the delay   was implemented to … 1. Surgery may not always be the best option according to a report that questions the value of arthroscopy and knee replacement for some common conditions.   Published   in the   BMJ   …
Article

Revolutionizing Specialty Services Management

… The Hidden Costs of Administrative Complexity Managing specialty services claims is a balancing act. Claims … that reduce claims handling accuracy and inflate operational costs unnecessarily. Nearly half of all claims lead to medical expenses ranging from $10,000 to $500,000, with the average claim costing $44,179 according to NCCI data . Adding to the complexity, the fragmented nature of specialty claims management creates substantial administrative burdens, draining valuable time …
News Release

Enlyte Celebrates Eight Winners of the 10th Annual Heart of Case Management Award

… 2025 marks highest number of awardees nominated by Enlyte customers and managers SAN DIEGO—A record eight Enlyte case … providing education and emotional support, while expediting authorizations, scheduling with top specialists and coordinating transportation. With her persistence, the employee reached MMI, … change of physician who confirmed the employee’s pain was not related to the original injury, an outcome that not only protected the integrity of the claim but also saved significant costs by …
Article

Surviving and Thriving During Challenging Times

… in fewer cars on the road and far fewer accidents . According to a recent survey , 52% of U.S. repair facilities reported a decline in sales in March 2020 as compared to March 2019 and … to demonstrate its resilience. Many shop owners have quickly transitioned to new ways of doing business that better support their customers and community. Others are taking advantage of downtime to focus on staff training and professional development. And all seem to be embracing …
Article

Measuring and Driving Performance in a Technology Shocked Industry

… The change in the complexity of vehicles over the last five years is absolutely staggering. We live in an age where every aspect of the automobile is being transformed. Cars are now being produced with a combination of … There are four primary steps to implementing an effective performance management strategy: … degree, and sports fans live vicariously through their favorite teams and feel the excitement of competition. It is important for team members to have an idea of how they stack up against …
Article

Property Damage Appraisers Gets Customers Back to Their Lives Faster by Helping Carriers Deliver on Their Promises

… has grown into a nationwide franchise organization. With 650+ appraisers serving thousands of clients, Property Damage Appraisers (PDA) completes an astonishing 450,000 estimates annually for auto, heavy equipment and property claims. How does a company that started as a college side project become one of the most successful damage estimating corporations in the nation? By building its brand on … would have the biggest impact on PDA customers. Knowing that cycle time (the average number of days it takes from the time of assignment to completion of a damage estimate) affects the cost …
Blog

Introducing Networks 2.0: Part Two

… This is part two of a four-part blog series on Networks in workers’ comp. Part one is available here . Treating … well. The injured worker isn’t responsible for paying a deductible or copay. This is becoming an evermore important differentiator. That’s because out-of-pocket costs can be difficult for … medical debt, according to Benedic Ippolito, a research fellow and health economist with the American Enterprise Institute. He contends Americans often think medical debt is different than …
Article

The Black Car Fund Delivers the Future of Benefits to Independent Workers Today

… compensation for for-hire vehicle drivers injured on the job. This statute was the first of its kind in the United States and covered all drivers affiliated with The Fund’s member … coverage for drivers who wouldn't ordinarily have it,” says Eric Hornick, CCO and actuary of The Black Car Fund. “Before the fund existed, there was no workers' compensation insurance for … model. Instead, it derives its funding from a 2.5 percent passenger-paid surcharge added on top of the fare. Over time it has enabled The Fund to become a self-insured and self-administered …
Article

2020 CPT Code Changes: What You Need to Know

… CPT Copyright 2020 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association. It’s that time of year again! The American Medical … Code Changes Here How will these CPT code changes for 2020 impact the casualty industry? After an intensive review of the new CPT code book, this article will discuss the most relevant 2020 … Deletion of Manual Muscle Testing Codes …
Article

2021 CPT Code Changes: Evaluation and Management Updates

… CPT Copyright 2020 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association. Nearly 30 years after introducing evaluation and management … changes include: Revisions to Evaluation and Management Codes (CPT codes 99201–99215) Deletion of CPT Code 99201 Elimination of History and Physical Elements for Code Selection To make these … set in 1992, replacing the prior service codes, which did not accurately reflect the level of effort for professional service visits. The evaluation and management codes were, and still …
Blog

Warnings about impurities in Zantac® and blood pressure medicines

… In September 2019, the U.S. Food and Drug Administration ( FDA ) reported the discovery of low levels of an impurity in brand, generic, and over- the-counter (OTC) versions of a popular heartburn …
Article

StateWatch Early Spring 2017

… study finds that 52 million adults under 65 – or 27 percent of that population — have pre-existing health conditions that would likely make them uninsurable … rates would be higher in other states, particularly in the South, where at least a third of the non-elderly population would have declinable conditions under pre-ACA underwriting … in 2017 . Black Book’s 2016 Revenue Cycle Management Survey showed that outsourcing of complex claims to specialized providers increased from 20.4 percent in all U.S. hospitals in …
Article

StateWatch Early Spring 2017

… study finds that 52 million adults under 65 – or 27 percent of that population — have pre-existing health conditions that would likely make them uninsurable … rates would be higher in other states, particularly in the South, where at least a third of the non-elderly population would have declinable conditions under pre-ACA underwriting … in 2017 . Black Book’s 2016 Revenue Cycle Management Survey showed that outsourcing of complex claims to specialized providers increased from 20.4 percent in all U.S. hospitals in …
Article

StateWatch Fall 2015

… Researchers from Johns Hopkins Bloomberg School of Public Health, Baltimore, and Washington and Lee University, Lexington, VA, have found that … maybe more susceptible to those markups than others. According to the report, Florida has 20 of the nation’s most expensive hospitals, while Pennsylvania is home to seven.  The FDA recently … International Association of Industrial Accident Boards and Commissions (IAIABC) is developing an informational packet on how formularies work for lawmakers and regulators, WorkCompCentral …
News Release

Congress Makes Moves to Weed Out Marijuana Restrictions

… businesses to allow them to provide banking services to the cannabis industry without fear of prosecution under federal laws. The bill had bi-partisan support and now heads to the Senate … action in the upper chamber. The Senate Banking Committee Chair, Mike Crapo (R-ID) did not express any interest in fast tracking the bill, but noted that he may schedule the bill for a committee hearing before the end of the year. Another bill related to marijuana is also currently running in the House. …
Article

U.S. Supreme Court Refuses to Hear Minnesota Workers’ Comp Cannabis Cases

… On June 21, 2022, the U.S. Supreme Court released an order list for a host of cases before the Court. As part of the list, the Court noted the … of a particular item, it preempts a state law requiring a private party to subsidize the purchase of that item.” The Office of the Solicitor General also pointed out that marijuana law …
News Release

Mazda Launches Collision Network to Consumers

… — Mazda North American Operations (MNAO) and Mitchell, an Enlyte company and leading technology and information … & Casualty (P&C) claims and Collision Repair industries, today announced the consumer launch of the Mazda Collision Network. With new website content and an online collision repair facility … About Mazda North American Operations … in Irvine, California, and oversees the sales, marketing, parts and customer service support of Mazda vehicles in the United States, Canada, and Mexico through approximately 780 dealers. …
Blog

Aggregate Trends for Top 10 Therapeutic Classes in 2019

… In 2019, the top 10 therapeutic classes accounted for 76.8% of all scripts and 79.6% of all costs. An understanding of the most-utilized and highest-ranked classes of medications by cost can drive …
Blog

Aggregate Trends for the Top 10 Therapeutic Drug Classes in 2018

… In 2018, the top 10 therapeutic classes accounted for 77.1% of all scripts and 81.0% of all costs. An understanding of the most-utilized or highest-ranked classes of medications by cost can help …
Article

A Checklist of 8 Support Team Qualities to Look for When Choosing a Casualty Solutions Software Vendor

… Slow or unreliable support can stall your teams, add costs, and erode trust. The quality of a vendor’s software product support team matters as much as the solution itself. Whether you … Consistent, well-documented processes across all products and services create a single source of truth, so you get consistent guidance no matter which product you use or who you speak with. … approach. Access to dedicated resources, expanded support roles, and multiple levels of expertise available provides the right level of engagement at every stage. …
News Release

Taking Heart in Workers' Comp

… Genex honors three difference-making case management professionals through new Heart of Case Management Award … Genex Services today announced the winners of its inaugural Heart of Case Management Award. The new award is designed to recognize case managers' expertise by … was having trouble with post-op recovery from a hand injury, Price-Benham worked with a top hand specialist to secure a diagnosis of reflex sympathetic dystrophy (RSD). They then …