This letter is to address the impact of Senate Bill 1160 (or SB1160) pertaining to self-insureds, TPA’s or third-party-administrators, employers, and utilization review organizations across California. On September 30, 2016, SB1160 was signed by Governor Jerry Brown, which is set for implementation beginning the first of January in 2018. The result of this bill will [...]
Workers comp administrators receive 200 to 300 bills a day which need to be directed to adjusters. However, the adjusters don't necessarily review the bill, even though numerous incidents occur when they are sent out for the wrong reason. Some of these reasons may include a bill for unnecessary treatments, fee schedules changing frequently, or even when [...]
"With the implementation of this program ... our medical costs have been very significantly reduced". Bill Zachry - Vice President of Risk Management at Safeway Stores In an article in Risk and Insurance magazine, Zachry encourages workers' compensation leaders to look for leakage in the gap between their own utilization review and bill payment practices. Closing this [...]
Between complying with the new regulations, mounting medical inflation and the need to find creative ways to manage cases, claims administrators everywhere have their hands full. As a result of added complexities in the claims world, the importance of increased organizational efficiency has never been as clear as it is today. When a company operates [...]
DataCare Customers Ahead of the Curve in Latest Survey of Workers’ Compensation Bill Review The 2012 Survey of Workers’ Compensation Bill Review by Heath Care Associates (http://www.healthstrategyassoc.com/2012BillReviewSurvey.pdf ) reports that the single biggest problem for Workers’ Compensation Bill Review is “the need to better and more completely link medical management determinations to the actual payment [...]
SAN JOSE, Calif., March 8, 2013 /PRNewswire/ — The failure of workers’ compensation claims payers to properly audit medical bills for prior approval of treatment is costing upwards of $2 billion or more annually, in unwarranted medical payments. This estimate is based on one firm’s analysis of medical payments over the past four years. In [...]