Archives for December 2013

While workers comp claims are dropping across the US, the amount of questionable claims is rising, according to a recent study of workers’ compensation fraud cases. The most common fraud cases are related to workers who exaggerate injuries, or completely fake them, as well as file for injuries that did not occur within the workplace.

The Los Angeles Times reported on September 24, 2013:

“Over the last 2 1/2 years, the number of workers filing compensation claims has dropped from 3.35 million in 2011 to 3.24 million in 2012, according to the National Insurance Crime Bureau, a nonprofit company supported by more than 1,000 insurance companies. Based on claims filed in the first half of this year, the number is on track to drop again, the bureau said. But in the same period, questionable claims have risen from 3,474 in 2011 to 4,460 in 2012 and are on pace to rise again in 2013, the bureau reported.”

How prepared is your company to handle these rising fraud cases?

If you answer “No” to any of the following questions, read on to find out how Advisen’s Workers Compensation Management Program guidebook can help you.

• Do you know how to determine the appropriate length of REAL MEDICAL disability or how long an injured worker SHOULD be out of work?
• Does your company TAKE CHARGE of the injury process immediately after the injury — or do the employees be in charge?
• Do you know the seven reasons to investigate a workers comp claim?
• Do your supervisors know the “red flags” of fraud?
• Are you using all SIX types of investigation?
• Do you know the FOUR times NEVER to use investigation?
• Are your adjusters able to identify medical terminology that signifies malingering?

The 2013 edition of Workers Compensation Management Program addresses ALL of these questions (and more) while walking you through the process of setting up appropriate procedures to reduce your WC costs 20%-50%.

Now, thru December 31, 2013, get the #1 selling WC cost containment guide for $100 off.

To purchase a copy, CLICK HERE.

Topics covered includes:

• Workers Compensation Basics
• Fundamentals of Cost Containment
• Working with Your Adjusters or TPA
• Injury Management Best Practice Roles and Responsibilities
• Communication with Employees
• Reporting a Claim
• Post-Injury Response Procedure
• Directing Medical Care
• Return to Work and Transitional Duty
• Other Indemnity Cost Containment Services
• Medical Cost Containment
• Physical Therapy & Physical Rehabilitation
• Pharmacy Benefits Management
• Controlling Fraud and Abuse
• Training and Building Commitment
• Claim Resolution and Settlement
• Safety and Loss Control
• Federal Employees Compensation Act

Related guidebook chapter summary:

Fighting Fraud and Abuse

Imprinted for Brokers, Carriers, and Associations

Books are available in bulk with your branding printed on the front and back covers. Learn more.

Want Something More Condensed?

The “Mini-Book” provides an abbreviated version of our complete manual’s 18 chapters and is a great handout for your clients. Each chapter is summarized onto one page for concise, valuable information at their fingertips.

According to an NCCI study, “medical expenditures [are] growing at a faster rate than indemnity benefits in workers compensation… which have been a significant driver of medical costs.”

 

In NCCI’s initial 2003 report, they concluded that “utilization (as opposed to price) increases were the driving force behind total per-claim workers compensation Rx cost increases.” Furthermore, in their most recent study, “NCCI demonstrated that increased physician dispensing is associated with increased drug costs per claim.”

 

Does your company have a plan in place to manage prescription drug use and abuse as it relates to Workers Compensation?

 

If you answer “No” to any of the following questions, read on to find out how the Your Ultimate Guide to Mastering Workers’ Comp Costs guidebook can help you.

 

• Do you know the main component missed by risk managers in Pharmacy Benefit Management (PBM)?
   
• Do you know the six reasons to use pharmacy benefit management?
   
• Does your Pharmacy Benefit Management program have both prospective and retrospective elements?
   
• Are you implementing the eight PROACTIVE Drug Management Techniques?
   
• Does your company consider the THREE PROBLEMS with narcotics for pain control and take preventative steps?
   
• Can your company properly review the drug management program of your Third Party Administrator or insurance carrier?
   
• Can you identify the key selection criteria for a PBM?
   
• Do your supervisors know the “red flags” of drug abuse?

The 2013 edition of Workers Compensation Management Program addresses ALL of these questions (and more) while walking you through the process of setting up appropriate procedures to reduce your WC costs 20%-50%.

 

Now, thru December 31, 2013, get the #1 selling WC cost containment guide for $100 off.

 

To purchase a copy, CLICK HERE.

 

Topics covered includes:

• Workers Compensation Basics
• Fundamentals of Cost Containment
• Working with Your Adjusters or TPA
• Injury Management Best Practice Roles and Responsibilities
• Communication with Employees
• Reporting a Claim
• Post-Injury Response Procedure
• Directing Medical Care
• Return to Work and Transitional Duty
• Other Indemnity Cost Containment Services
• Medical Cost Containment
• Physical Therapy & Physical Rehabilitation
• Pharmacy Benefits Management
• Controlling Fraud and Abuse
• Training and Building Commitment
• Claim Resolution and Settlement
• Safety and Loss Control
• Federal Employees Compensation Act

 

Related guidebook chapter summary:

Managing Prescription Drug Use and Abuse: Implementing a Pharmacy Benefits Management Program

 

Imprinted for Brokers, Carriers, and Associations

 

Books are available in bulk with your branding printed on the front and back covers. Learn more.

 

Want Something More Condensed?

 

The “Mini-Book” provides an abbreviated version of our complete manual’s 18 chapters and is a great handout for your clients. Each chapter is summarized onto one page for concise, valuable information at their fingertips.