Article

CMS to Accept Electronic Payments for Conditional Payments

… fee to use Pay.gov. The site will accept the following forms of payment: Checking or Savings Account Debit card PayPal (accounts must be linked to a bank account and not a credit card) For Checking or Savings accounts the maximum amount that Pay.gov … Pay.gov can contact Customer Support at (800) 624-1373 (Option #2) from 7am-7pm EST or via email:   pay.gov.clev@clev.frb.org. For more information/questions about MSPRP Electronic …
Article

CMS to Accept Electronic Payments for Conditional Payments

… fee to use Pay.gov. The site will accept the following forms of payment: Checking or Savings Account Debit card PayPal (accounts must be linked to a bank account and not a credit card) For Checking or Savings accounts the maximum amount that Pay.gov … Pay.gov can contact Customer Support at (800) 624-1373 (Option #2) from 7am-7pm EST or via email:   pay.gov.clev@clev.frb.org. For more information/questions about MSPRP Electronic …
News Release

New Account Maintenance Feature Now Available in Mitchell SmartAdvisor Platform

… Mitchell recently released Account Maintenance, a new feature in its SmartAdvisor bill review platform that boasts an … for configuring their unique systems settings within the SmartAdvisor application. The Account Maintenance feature provides an efficient and consistent method for SmartAdvisor … edits across multiple levels, helping them avoid manual and repetitive configurations. Account Maintenance is designed to provide a few key benefits for SmartAdvisor bill review …
Article

A Guide to Making Specialty Bill Review a Good Fit for You: An Account Manager's Perspective

… stands out as a powerful tool for achieving significant savings. Chad Countryman, a seasoned account success director at Enlyte, shares his insights on how he coaches clients to understand …
Podcast

Is Your Workplace Safe2Work?

… to help the employee come back faster. That is why we decided to build the Safe2Work app on top of that and add it into this very robust system for trackability and ability to actually … It’s a really good question. It could be done either way. We can give it the ability to send an email to the HR person saying, “This person has recorded a positive indicator for possible COVID … Optis meets all the security requirements for housing personal, employee data. And that email is sent out, not providing any specifics to the case but, providing the HR manager or …
Article

Ask The Pharmacist: Understanding the Different Types of Drug Recalls

… If you have questions or concerns regarding drug recall information, please contact your Account Manager. Do you have a workers’ compensation or auto related pharmacy question? Send us an email at AskThePharmacist@enlyte.com . To read more Ask The Pharmacist articles, please visit …
Blog

2019 Recap

… shared 47 posts. We thought it fitting to cap off the end of the year, with a review of our top three most viewed posts. The Drug Trends Series posts were the big winners in 2019 with 82% … Egypt, France, Australia, Denmark, Ireland, and more. Read on to see some stats regarding our top three posts and our recommendations.  … 2nd most viewed post: Top 5 Opioid Medication Trends in 2018 … 3rd most viewed post: Investigating the Top Therapeutic Classes …
Article

Ask The Pharmacist: The Role of Topical Medications in Workers’ Compensation

… According to the Workers Compensation Research Institute (WCRI), these products now account for approximately 22% of total medication payments. Dermatological agents and NSAIDs continue to be top cost drivers, and both the number of injured employees using topical medications and the … Top 3 Topicals by Cost … pharmacist. Do you have a workers’ compensation or auto-related pharmacy question? Send us an email at AskThePharmacist@enlyte.com . To read more Ask The Pharmacist articles, please visit …
Article

Specialty Solutions Spotlight: Using Quality Physical Therapy First for Low Back Pain Helps Reduce Costs and Improves Outcomes

… attributed to overuse or unnecessary services . In workers' compensation, physical therapy can account for up to 20% of medical costs, making it crucial to ensure appropriateness and quality … make a referral for specialty solutions services, call us today at 877.203.9899 or send an email to mailto:referrals@apricusinc.com referrals@apricusinc.com .   Resources: …
Article

Specialty Solutions Spotlight: Cybersecurity Risks With Internet Connected Medical Devices

… To make a referral for specialty solution services, call us today at 877.203.9899 or send an email to referrals@apricusinc.com . Resources: …
Article

Ask The Pharmacist: What Adjusters Need to Know About Trubrexa, a High-Cost Topical Analgesic

… options. This pricing disparity creates significant cost concerns , particularly when: PLTAs account for only 3.9% of prescription volume but 20.5% of total pharmacy costs. Opportunistic … pharmacist. Do you have a workers’ compensation or auto-related pharmacy question? Send us an email at AskThePharmacist@enlyte.com . To read more Ask The Pharmacist articles, please visit …
Article

Specialty Solutions Spotlight: How to Keep Workers’ Compensation Home Modifications on Time and on Budget

… durable medical equipment and other services, call us today at 877.203.9899 or send an email to  apricus.referrals@enlyte.com .    …
Author

Jim Begg

… in the workers’ compensation industry since 1987 and has extensive experience in various account management and sales roles. Jim is responsible for the oversight of the Specialty Solutions account management team, directly oversees key accounts and works closely with the operations …
News Release

August 2022 Utilization Review Compliance Update

… timely to carrier for the submission. The state has not yet determined a method of submission (email or particular form) but will let us know when this is decided   … about any of the information presented, please do not hesitate to contact your client account manager. Or you may reach out to a member of the Genex UR Compliance team whose … Camille Pruitt, Quality Assurance Auditor 2, Quality Improvement Team Phone: 520.416.8458 | Email: Camille.Pruitt@genexservices.com Isey Harris, Manager Compliance and Regulatory Affairs …
News Release

September 2022 Utilization Review Compliance Update

… about any of the information presented, please do not hesitate to contact your client account manager. Or you may reach out to a member of the Genex UR Compliance team whose … review organization shall also include the name, address, and appropriate contact number or email address of the utilization review physician making a denial determination. … the compliance contact, and the attorneys. If there is no existing compliance contact email, the email for the adjuster’s supervisor, the office manager or other liaison shall be …
Article

CMS Releases Version 3.0 of WCMSA Reference Guide

… corrected or clarified for reporting workers’ compensation cases; for sending yearly WCSMA account attestations; and for sending WCMSA proposals, final settlements, and re-review requests … Note). The Life Table link has been updated (Section 10.3). This guide has been updated to account for changes in the WCMSAP, which now includes a Professional Administrator role, which can upload account transactions and view account details, and the ability to submit attestations online for …
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 .    …
News Release

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

… prior authorization requests should be sent to the carrier or administrator's designated email found on the Board's website. Since many individuals are now working remotely, faxes may … Board also noted that fax documents should be forwarded to the insurance carrier's designated email contact to ensure that requests are being processed. …
Article

The Long, Winding Road of Drug Pricing
Author

Julie Black

… clinical program management, Drug Utilization Assessments and Provider Outreach, and clinical account management. Prior to joining Pharmacy Solutions, Julie served as a clinical liaison for a … industry having worked previously in the areas of clinical operations, product development and account management. In addition, Julie has experience outside of workers’ comp, including …
News Release

Symbicort Generic Approval on March 15, 2022

… or future impacts assessments, pricing information, or recommendations, please contact your Account Manager or Account Pharmacist. …
Article

DevSecOps: An Interview with Peter Chestna at Mitchell DevCon 2018
White Paper

Ten Workers’ Comp Specialty Services You Should Know More About

… when they need it. This on-point, on-time care is more important than ever. High-cost injuries account for a larger share of claims – and specialty services account for a significant share of this spending. Having the know-how to oversee specialty …
Article

10 Work From Home Tips During COVID-19 for Insurance Professionals

… we are all searching for ways to make this experience more bearable, even productive. And on top of that, in the insurance industry, we are also trying to figure out how to keep our … messenger and collaboration tools like Microsoft Teams and Slack, and our good old friend—email! We must step up our digital communication game. … Practice Good Email Etiquette … Speaking of email, now more than ever is an excellent time to review the basics of good email etiquette. …
Article

CMS Commercial Repayment Center (CRC) Contractor Transition

… the stakeholder community and improved communication between BCRC and CRC. A special inquiry email address  crcnghpinquiries@performantcorp.com  has been established for questions. The special inquiry email will be activated on February 12 th . We at Genex are looking forward to working with Performant and cannot wait to try out the special inquiry email for your most pressing CRC recovery questions. For more information/questions about the CRC …
Article

CMS Commercial Repayment Center (CRC) Contractor Transition

… the stakeholder community and improved communication between BCRC and CRC. A special inquiry email address  crcnghpinquiries@performantcorp.com  has been established for questions. The special inquiry email will be activated on February 12 th . We at Genex are looking forward to working with Performant and cannot wait to try out the special inquiry email for your most pressing CRC recovery questions. For more information/questions about the CRC …
Article

Stop the Specialty Service Spiral
Article

Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Updates and MSP Portal Enhancements

… 4) Password/Account Recovery Assistance … A new Forgot Password feature on the Welcome to the MSPRP page allows users to unlock their account, if locked after three unsuccessful login attempts, or to reactivate an inactive account (Sections 6.3, 6.4, 7.5, and 18.7). …