Article

Stress Management: Doing Breathing Exercises

… message to your body. Some 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 start if you have never done breathing exercises before. It's simple to learn and easy to do. After you have mastered belly breathing, you may want to try one of these more advanced … Practice this breathing method 3 or 4 times a day for about 10 minutes each time. When you can do this type of breathing well while lying down, learn to do it while sitting or standing. 4-7-8 …
Article

When Do You Need an MSA?

… or collections. So, when considering Medicare Set-Asides, it’s important for payers to do their due diligence. Following these basic guidelines can go a long way in ensuring the …
Blog

Why do customers love live chat?
Article

When Do You Need an MSA?
Podcast

Do You Need a Medicare Set-Aside?

… It is considered part of a workers' compensation claim. We do have some clients that will ask us to do Medicare Set‑Asides for liability claims. At this time, there are no rules in place by … to pay for your accident‑related treatment. The problem that we have a lot of times is we'll do the MSA for our client, and the case will settle but nobody actually ever explains to the … because I used my Medicare card, and now they're sending me a bill. And, what am I supposed to do?" And, that happens because no one has explained to them that that's the fund, that they're …
In the News

What’s AI really doing for claims management?
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Before You Choose a PBM, do the Math
Article

Case Management: Can Any Nurse Do it?

… Today, we’re talking with human resources expert Debbi Bromley to find the answer. Debbi, how do you go about finding nurses willing to make that transition? … they don't even know that workers' comp exists sometimes, we're a small niche. So we have to do that promoting. We have to look for nurses that no longer are interested in clinical work, … because a lot of nurses go to nursing school because that's what they think they want to do. They want to be in a hospital. They want to do clinical‑type work, and our work is a little …
Article

Beyond the Buzz: Do You Have GenAI FOMO?

… to integrate generative artificial intelligence (GenAI) into their programs, but what do we really need to understand about leveraging AI effectively and responsibly for P&C? … If businesses don't stay on top of the latest trends and start delivering value immediately, they risk alienating customers …
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What Do We Know About Post-COVID Conditions?
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What does tesla have to do with healthcare?
Podcast

Medication Safety: How Do We Solve the Problem?

… multimedia series in which subject matter experts discuss problems and offer solutions to top issues affecting our industry. I’m Tom Kerr, and in part two of our discussion, Ron Skrocki, … system linkages. Secondly is the whole technology issue. For some payers, it's very hard to do this. Our business is not known for attracting a lot of system development dollars and a lot … case management role. What we’ve learned about this, and I think other companies who do this well know, is that this problem is big enough, is thorny enough, is difficult enough to …
Blog

What Will Opioid Legislation do for Pharmacy and Opioid Risk Management?
Article

WCF Insurance Proves that Doing the Right Thing is Good for Business

… drive change. As the largest workers’ compensation insurer in Utah, WCF realized it had to do more to tackle the growing opioid crisis to ensure injured workers could safely return to work … carriers and pharmacy managers who recognize that we all need to get on board because can’t do this by ourselves,” says Stauffer. WCF is fully committed to doing its part to combat the …
Article

Changing Workforce: What to Do Now Before Your Best Bodily Injury Claims Adjuster Retires

… contributing to a 401K, figuring out your cost of living and deciding what you’re going to do with your time once you aren’t occupied 40 hours per week. But for insurance companies, … workplace continues to evolve, claims organizations are faced with a pressing question: “How do I prepare for when my best and most seasoned adjusters retire?” … technology platform can help insurance carriers capture the best practices from their top adjusters throughout the organization. This type of technology platform is set up based on …
Podcast

Making Change Happen in WC: What’s Holding You Back?

… that don't really align with the process, with the ultimate outcome or goals. I have to do it cheaper and better. Well, if cheaper only means how much does it cost to do it, then I think that's hard to do, particularly if you won't allow me to sort of connect with or integrate or enhance your … compelling end goal reason to make them. Because those changes in process and the way people do things are hard to change when you don't have sort of a compelling end in mind …
Podcast

Why Telephonic Case Management Is Not One-Size-Fits-All

… program can go a long way in helping payers boost their return-to-work outcomes. But how do you go about finding the TCM program that’s right for you? On today’s podcast Dawn Moore, … have programs that they somewhat manage on their own. We have other prospects where they don’t do anything at all. So, the first opportunity is just doing a needs assessment on what clinical services from Genex we can offer the client to be able to supplement what they do. We can do everything from intake all the way through triage to case management referrals to …
Article

Need-to-Know Tips for ADAAA Compliance

… the employee wants to continue to work, we need to look at, based on your request, what can we do about it. So, you need to show good faith that you're doing that. Having job descriptions that … or the cognitive aspects. They should provide training to their managers about what to do when they see a request and what might be the process. They may be brought into the interactive process to say, “what can we do to change a job? Can you change a job and still meet the requirements?” It could be something …
Article

Need-to-Know Tips for ADAAA Compliance

… the employee wants to continue to work, we need to look at, based on your request, what can we do about it. So, you need to show good faith that you're doing that. Having job descriptions that … or the cognitive aspects. They should provide training to their managers about what to do when they see a request and what might be the process. They may be brought into the interactive process to say, “what can we do to change a job? Can you change a job and still meet the requirements?” It could be something …
Article

Leveraging Direction of Care in Workers' Comp to Address Drug Pricing

… And so, regulators around the country are really struggling, trying to figure out what to do about it. In fact, [recently] there was a hearing in Arizona and one of the big focuses was, how do we deal with these outlying drugs that are really super expensive? And how do we curb the fraud and abuse? And I know the chairman Schultz down there went on a fairly long … are the ones that set the AWP for their drugs themselves, but what the regulators can do that you highlighted is doing direction of care. Can you tell us a little bit more about what …
Article

From RPA to Cobots: Automation in Insurance and Collision Repair

… process automation (RPA) is the automation of repetitive tasks that humans would normally do. RPA can automate both front and back office processes, including tasks that happen all the … to another and taking notes. The general idea is that if a task takes a person two minutes to do, and that person typically does that task 30 times a day, he or she would have an hour each … for you. The artificially intelligent personal assistant is remarkable both for what it can do and for how human it sounds. The technology feels futuristic, but it’s not far off. Google …
Article

Cobotics, a New Type of Man-Machine Collaboration

… fiction narratives where malicious robot overlords render people obsolete, robots are here to do something surprisingly human: collaborate. Cobots, short for collaborative robots, share … or otherwise undesirable for humans. Cobots, short for collaborative robots, are here to do something surprisingly human: collaborate. Hamburger chain Caliburger provides an example of … heat in the kitchen—they turned to an artificial intelligence-enabled robot named Flippy to do the job. After a rough start, the company realized that since Flippy can’t quickly respond to …
Article

Outsourcing Your Medical Bill Review Process: A Comprehensive Guide

… has put a lot of pressure on workers’ compensation and auto casualty claims organizations’ top and bottom lines, which, in turn, has caused many companies to adjust their operating models … Do you have a plan in place in case of an outage or emergency, or a plan to quickly scale as a … or difficulties managing change—or don’t have the structural elements in place for when they do happen—it may be a sign that you should consider outsourcing.   …
Blog

How to Find the Best Providers

… time? There are industry guidelines that the providers know about, that we know about, that we do evaluate the provider's performance against. And, if a provider is only treating those that … to work, or temporary duty, then we consider those as better providers than others that try to do their own thing without case management intervention. But, it's also around indemnity, which … medical spend, we'll look for that in the data and those are the providers that we'll consider top tier. …
Podcast

Using Remote Therapy Monitoring to Improve Compliance Costs in Comp

… or adjunct to the physical therapist. It monitors either through a patient check‑in (they do the home exercise programs and mark when they’ve completed it), or the more advanced tools … The primary barriers are going to be the patient’s access to the necessary technology to do remote therapy monitoring. Most of it requires some kind of smartphone device. Usually, an app … it’s an app on a smartphone. Now, that is becoming less and less of a problem, right? But you do have populations of workers that may not have the best technology. And also, just their …
Blog

What is an MCO?

… workers seek to get on the road to recovery.  However, usually the question has more to do with State Certified Managed Care Programs, commonly referred to as MCOs.  From there it gets … usage and demonstrate success of the MCO in the overall claim management process. Some will do the MCO filing with the legislative bodies and others will provide you with the documentation to do the filing yourself – often times this differs depending on who is stringing the MCO program …
Article

Alternative Transitional Duty: A Win-Win for Employee, Employer and Community

… And what types of challenges do employers have in developing transitional duty opportunities? … demand restrictions on that employee, then the employer will consider, “Can I bring them back? Do I have a job that works within these responsibilities?” If they don’t, then they will consider … apt to get a case in a remote area of the country. So, a lot of different businesses. We also do work with two big carriers. So, we don’t ever know what kind of employer that that they’re …
Article

Prepare for IAIABC Claims Release 3.1 by Starting with Your EDI Reporting Process

… like to share a few things to help your organization prepare for the implementation. 1. How do you handle Claims EDI Reporting today? The first step in deciding how to move forward with … 1, 2, and 3 Claims EDI Reporting. Does your company manage their EDI reporting in house or do you use a vendor? How is the process working for you? Now may be a good time to explore your … your specific needs which may reduce the overall build and ownership costs in the long run. 2. Do you have the resources required to launch an implementation? Whether you choose to partner …