Archives for June 2018

Workers Compensation Medical Software vs My Semi Annual App Search

June 28, 2018 By JL Risk Management Consultants

Workers Compensation Medical Software Companies Say – How About Us?

Workers Compensation medical software companies have been chatting with us by email, calls, LinkedIn, comments, etc. over the past few weeks. As you may know I have written a number of articles on the lack of workers compensation technology including apps for iPhones and Android phones.

picture of boy looking at workers compensation medical software binoculars

Wikimedia License Jrod2

I searched for technological advances at the NWCDC conferences over the past few years. I discovered a few companies that were on the cutting edge including a genetic pharmaceutical company and two online doctor visit providers.

In fact, I have called the Android/Iphone searches “going into the rabbit hole.” << a tip of the hat to Charles Dickens.

Workers Compensation medical software company owners and their marketers have informed me directly or indirectly that I may have overlooked them. I am not and will not endorse any companies. However, I will refer back to the article where I set out the rules I was using to find the Workers Comp apps. If not, the credibility of my searches would have been less than zero.

For 2018 Android searches –

Be free
Not be a veiled advertisement
Have at least 10 votes on the ratings – this prevents the app providers from rating themselves highly. – this is a new requirement
Have at least 3 stars or higher rating – this is a new requirement
Have some useful function – (that it actually worked)
Be closely related to Workers Comp
Appear in the Google Playstore – some websites provide apps that are not in the Playstore. A great marketing idea would be to put them in the Playstore as blatant advertising. Some recommended apps no longer appear in the Playstore.

The rules were not very picky. #3 in the above list kept the providers from rating themselves highly and not the app users.

For 2018 Iphone (Apple iStore ) apps , the same rules applied to my searches. The one astonishing discovery noted was the lack of workers compensation apps for iPhones.

I appreciated the contacts from various software companies – actually medical treatment platforms. This means that my searches will bear more fruit in the future – at least (hopefully) from workers compensation medical software companies.

©J&L Risk Management Inc Copyright Notice

Workers Compensation Reserves – Fee Schedule Hidden Benefit

June 27, 2018 By JL Risk Management Consultants

Workers Compensation Reserves More Accurate With Fee Schedules

Workers Compensation reserves (Total Incurred minus Paid) receive an accuracy boost with fee schedules. Why? – Let us go into the mind of an adjuster getting ready to set permanent file reserves at 60 days.

picture of archer workers compensation reserves target

Wikimedia License – Jethrothompson

BTW, this articles stems from an article I wrote last week. I promised in that article to mention how fee schedules help increase reserve accuracy.

Very few adjusting staffs sit down with a medical reserve and read it out of the state fee schedule. Usually, the adjuster has a list of blanks to fill in to come up with the file reserves. Areas such as surgery, hospitalization fees, physical therapy, etc. are listed on the sheet.

The Workers Compensation reserves at the 60 day mark are for the life of the file. An experienced adjuster with 7+ years into their career has a great feel for reserving in a state with fee schedules. The states with Usual & Customary (U&C) are more of a negotiated price. If you have ever received a U&C bill in a health insurance matter, you are shaking your head – yes. It is by zip code and area of specialty and on and on.

With fee schedules, the adjuster can easily say -OK- the price of treatment for a non-compound ulna fracture (after filling in the aforementioned blanks) is $23,545.00. With U&C, the adjuster creates even more of an estimate as the adjuster has to know the price of medical treatment for every specialty in every zip code. Whew! – that is not easy.

man wrapping injured workers compensation reserves woman

by StockUnlimited

I became very experienced in the U&C area after I received two boxes of paper files from a failed captive in a run-off situation. Some of the providers had not been paid for quite some time. All the injured employee bills originated in non-fee schedule states. The ever complicated negotiation was on – by each zip code, and even some of the U&C Zip Codes were split.

In a fee schedule based state, I could have sent the bills for processing through a bill review company. The charges would have been paid – possibly with an applicable late fee. The task turned out to be not that easy.

Workers Compensation reserves with a fee schedule state have one set of numbers to use in the complete state – in most cases. A few fee schedules have a synthetic add-on such as BR (By Report).

A disclaimer – I am not a U&C health insurance expert. I am more versed in Workers Compensation reserves.

©J&L Risk Management Inc Copyright Notice

Stay at Work Washington L&I ‘s Unique Program – Guest Post

June 21, 2018 By JL Risk Management Consultants

Stay at Work -How Washington State Companies Can Be Reimbursed

Up to 50% of an Injured Worker’s Light DutyWages

Stay at Work sounds like a great unique program for employers and injured employees.

Two months ago, Mr. Kohler (see below) contacted me. He wanted to see if I would be interested in posting a guest post on the unique state of Washington’s Workers Compensation system.

graphic of worker lifting improperly stay at work

Public License – Wellcome Foundation, UK

I admit that I do not allow very many guest posts. Washington’s L&I (think monopolistic) is unto itself on many aspects of Workers Compensation. Mr. Kohler made me an offer that I could not refuse. Below is the article he wrote verbatim.

___________________

The Washington State Department Labor and Industries (L&I) has a unique program called “Stay at Work” that is designed to help employees stay on the job after an injury claim has been filed. The program is geared to meeting both the needs of injured employees and employers that are worried about managing all of the costs associated with an employee injury claim.

What is “Stay at Work”?

“Stay at Work” is a financial incentive program that reimburses employers for some of the costs of transitioning an injured worker to temporary, light-duty jobs while they recover from their injuries. Eligible employers are able to get reimbursed from L&I for eligible expenses.

The program was created to deal with the issues faced by both employers and employees when an injured employee is kept off the job of injury for months at a time.

The employee, even with worker’s compensation, payments can see as much as a 30% to 40% reduction in their take-home pay. Also, the longer an employee is out of work, the more difficult their recovery becomes and the harder it is to get back to work.

“Stay at Work” encourages employers to find temporary light-duty jobs for injured employees so that they can continue to participate in the workplace. This improves their health outcomes and allows them to avoid a reduction in their take-home pay.

Woman Stay at Work Sitting on Wooden Planks

by StockUnlimited

How Does “Stay at Work” Help Employers?

The “Stay at Work” program also significantly helps employers. Instead of dealing with all of the costs associated with an injury claim, the employer is able to be reimbursed:

50% of injured worker’s base wages for light-duty or transitional work
Expense reimbursement for training, tools, and clothing

This program not only reduces the costs the employer faces in dealing with an injury claim, it allows the employer to still take advantage of the skills and knowledge of the injured employee while they heal. It also makes it more likely that the employee will be able to return to full duty.

Key Eligibility Requirements

Some of the key eligibility requirements for the “Stay at Work” program include:

Pay workers compensation premiums to L&I
By the employer at the time of the injury on the claim, or have your experience rating affected by the claim
Have written approval for light-duty or transitional work from the employee’s health care provider
Apply for reimbursement of eligible expenses within one year of incurring the expenses

The “Stay at Work” program gives employers the chance to get some help with the often-excessive costs of managing an employee injury claim. The program is good for employers and employees.

Spencer Kohler – ARM, V.P. Marketing, Risk Finance/Washington Manufacturers Council provided this Stay at Work article.

©J&L Risk Management Inc Copyright Notice

Workers Compensation Fee Schedules Win Again – WCRI’s Free Study

June 19, 2018 By JL Risk Management Consultants

Workers Compensation Fee Schedules = Less Costly Claims and Premiums

Virtually all Workers Compensation Fee Schedules cut comp costs across the board. Check out this search for fee schedules articles on this website. WCRI just published a massive study on workers compensation fee schedules. The study covers 87% of the workers comp benefits paid in the US.

pic of student studying workers compensation fee schedules

Public Use License Wikimedia Gnarlycraig

WCRI Says Freebies On This One

Dr. Rebecca Yang and Dr. Olesya Fomenko’s extremely comprehensive study covers 35 states. These two researchers are data geniuses along with all the staff at WCRI.

For many years (over 11) I have written numerous articles on fee schedules. Why?- because they are governmental interventions that usually totally works to reduce the cost to employers, carriers, and all other parties. Next week, I will cover the hidden side of fee schedules that are just as important.

Virginia just enacted a fee schedule. For some reason, I thought Virginia would never have a fee schedule. Some tweaks will likely be needed for their fee schedule.

From the WCRI press release and website:

The study, WCRI Medical Price Index for Workers’ Compensation, 10th Edition (MPI-WC), compares medical prices paid in 35 states and tracks price changes in most states over a 10-year span from 2008 to 2017 for professional services billed by physicians, physical therapists, and chiropractors. The medical services fall into eight groups: evaluation and management, physical medicine, surgery, major radiology, minor radiology, neurological testing, pain management injections, and emergency care.

One interesting development pointed out by WCRI is the following states had major fee schedule changes:

Arizona
California
Colorado
Illinois
Kentucky
Massachusetts
North Carolina
Texas.

Woman workers compensation fee schedules using computer

by StockUnlimited

The rating bureaus such as NCCI (most of nation) and WCIRB (California) both provided numerous articles on fee schedules reducing costs.

The following is a sample of the WCRI study’s findings: (directly from their website)

Prices paid for a similar set of professional services varied significantly across states, ranging from 26 percent below the 35-state median in Florida to 158 percent above the 35-state median in Wisconsin in 2017.
States with no fee schedules for professional services had higher prices paid compared with states with fee schedules—39 to 168 percent higher than the median of the study states with fee schedules in 2017.
Changes in prices paid for professional services exhibited variation across states, spanning between a 17 percent decrease in Illinois and a 39 percent increase in Wisconsin over the time period from 2008 to 2017.
Most states with no fee schedules experienced faster growth in prices paid for professional services compared with states with fee schedules—the median growth rate among the non-fee schedule states was 30 percent from 2008 to 2017, compared with the median growth rate of 6 percent among the fee schedule states.

I think we can draw a direct conclusion from the studies by NCCI, WCIRB, and especially WCRI. States can only help themselves by enacting and properly adjusting their workers compensation fee schedules.

©J&L Risk Management Inc Copyright Notice

$250,000 Claim Reserve Level – Why Is that Number So Important?

June 15, 2018 By JL Risk Management Consultants

$250,000 Claim Reserve Level Creates Many Critical Responsibilities

The $250,000 claim reserve level causes many necessary actions. Some of them are obvious. The other not-so-obvious actions are just as important.

Please note that the Reinsurer and Excess Insurer are the same for this article.

Picture of Turkish Money $250,000 claim reserve level

Public Use License with permission

Usually, a claim that reaches this level involves Vice President or Examiner approval to input the reserve into the system. The checklist action plan can be enormous at this level to the claims adjuster.

Some of those tasks are:

Reinsurance reporting – This area can slip by if one is not careful. The $250,000 claim reserve level will likely cause some type of flag to the reinsurer. It never looks good if the reinsurer has to ask the claims staff for the report. The reinsurer should have some prescribed report they wish to receive at the $250,000 and higher claim reserve levels. Each reinsurer may require a totally different type of report.

Employer reporting – Completion of this task needs to occur before they reserves are entered into the system. Apprising an employer of this reserve level will save many headaches in the future. Many times we receive loss runs where a large reserve exists on the file with no explanation.

Money $250,000 claim reserve level in money clip

by StockUnlimited

Assigning to Field Case Manager or Rehabilitation Nurse – When a file hits the reserve level, better late than never to assign out a rehabilitation nurse Is there any reason to not assign it out to one? Medical control is mission critical along with a strong return to work plan. The rehab nurses are one of my favorite risk management techniques.

Subrogation Liens Must Be Covered – An interesting fact from a report by Mark Walls of Safety National is 24% of all huge claims in their inventory result from automobile accidents. Obtaining a police report is an easy task. Do not be the adjuster that forgets to cover their subrogation. We see no effort to pursue subrogation in files quite often. Writing a subrogation lien letter takes such a short amount of time.

Employer Involvement – Claims that reach this level must be followed closely by the employer. Did you send the employee to your carrier or TPA’s recommended industrial-minded physician? Do you have a modified duty job available? Are you in contact with the injured employee and keeping up with their medical treatment? What restrictions does the injured employee have at this point? An active employer usually reduces the cost of the claim while providing their injured employee with the best care.

These are a few things to cover when a claim is initially set or increases to a $250,000 claims reserve level.

©J&L Risk Management Inc Copyright Notice

WCIRB Pure Premium Rates Are Not Insurance Carrier Rates

June 12, 2018 By JL Risk Management Consultants

WCIRB Pure Premium Rates Not The Same As Workers Comp Insurance Rates (Usually)

The WCIRB pure premium rates generated a few calls over the last two weeks. Insurance companies file their own loss cost multipliers or LCM’s that deviate from those rates.

question mark wcirb pure premium rates in circle

Wikimedia Public Use License

The Workers Compensation Insurance Rating Bureau is the rate bureau for specifically California.

The insurance carriers can increase or decrease their rates from the pure premium rates. They are also referred to as advisory rates.

A definition of advisory pure premium rates by the WCIRB: (See this online PDF File for a Rate Filing Example. )

Pure premium rates, which reflect loss costs including loss adjustment expenses per unit of exposure, are only advisory and insurers are not required to use either the proposed or the approved pure premium rates in establishing the rates it will charge.

The rates have to be approved by the Insurance Commissioner at a hearing. The Commissioner has rejected any pure premium rate increases in the past.

The one great development is that companies are researching their policy information. Reading your policy is the first step in reducing your Workers Compensation premiums.

Please note that I am only referring to the rates. I am not referring to the Classification Codes. If your company has what you feel are inaccurate classification codes, those may be disputed. And where do you find the procedure? Yes, that is right – in your Workers Compensation policy.

The Insurance Commissioners in all states require that it be in every policy. No, really – it exists inside your policy.

The pure premium rates are reviewed for changes constantly by the WCIRB’s Actuarial and other committees. The bureau publishes any rate change recommendations on their website in various reports. The reports are usually produced on a semi-annual basis.

You may want to surf their website for more subjects beyond the WCIRB pure premium rates.

30 Minute Webinars – Trend Of Rushed Presenter

June 7, 2018 By JL Risk Management Consultants

New 30 Minute Webinars Trend – Presenters Rushing Through Information and Slides

Most 30 minute webinars sound like a great idea on the screen or paper. In practice, they seem to be an exercise in rushing.

I have listened to three webinars over the last two weeks that were of the new 30 minute webinar trend. Two of them sounded like a sprint that left the presenter(s) breathless.

Wikimedia License – The Photographer

One recent 30 minute webinars example presented by the WCIRB (California’s Rating Bureau) was good but left little time for questions. I am writing an article on the WCIRB webinar tomorrow. One large distinction with the WCIRB is that they have always been excellent in answering any questions that I had over the years.

The difference between the rushed webinars and ones that should fit into a smaller time slot originates from the presenter’s preparedness. I am not saying that any of the webinar presenters come unprepared for their slides.

Oh no, I think the difference is that their old webinar covered one hour. The presenters decided – hey, I will just cover the same slides more quickly. That situation occurred twice this week.

Ironically, one webinar was sponsored by a webinar presentation assistant/consultant company. The presenter covered 1/4 of what was on the slides. The results were not disastrous, but somewhat comical.

We are all time-pressed, or at least think we are under clock-based pressures.

crop image of man staring at 30 minute webinars clock

by StockUnlimited

I discussed the 30 minute time slot idea with one person that performs many webinar-based presentations. They said the drop rate at 30 minutes totals to a huge number when examining the participation numbers.

Could it be the quality of the presentations or the webinar did not apply to the listener, so they just gave it 30 minutes and then signed off? Of course, the attention span of the average listener is twenty minutes. The 20 minute figure was tallied long before the smartphone effect.

The old(?) format was 45 – 50 minutes and then 10 minutes for questions. From what I have experienced, the listeners that stay beyond 30 minutes are actually very interested in the topic. When I present a webinar, the participants that hang in there for the whole presentation are often the ones that follow up with me by email within the next 10 days.

Are all webinars going to the 30 minute format? Will this spill over into mini-in-person-conferences? Can a presenter or presenters compress their ideas that compactly? What is your opinion on 30 minute webinars?

Cutcompcosts Awarded Top 25 Workers Comp Blogs Again for 2018

June 5, 2018 By JL Risk Management Consultants

Cutcompcosts Repeats As Top 25 Workers Comp Blog In 2018

After Cutcompcosts repeated as Best’s Recommended Insurance Advisors, we just discovered that Workerscompensation.com awarded us with the Top 25 Workers Comp Blogs designation. We also were awarded the distinction in 2017.

Wikimedia Public License – Thomas Quine

In fact, we just received the 10 Year Badge for Recommended Insurance Advisors or Experts by Best’s Insurance Ratings. By the way, we are not bragging whatsoever. We just wanted to let our new and devout blog, article, and newsletter readers know that they are not reading or receiving spammy disguised advertising information.

We do need to add our 2018 Best’s Recommend Insurance Experts Badges very soon.

Please note that you see no ads in any of the articles, archives, or newsletters. Also, no annoying pop-ups were ever allowed. Many Google or SERP experts wanted us to monetize the blog <yuck>. I told them – no way – in no uncertain terms.

We have been offered thousands to list adverts on our blog and website. To that I said – that does not follow the vision statement for the website at all – so thanks, but no thanks.

I used to write articles for Google rankings, but no longer do I even attempt to do that. Google has somehow figured out when you just write and not worry about how the article will rank – will be more beneficial than writing an article to get it placed on the first page of the Google organic rankings.

Hand Draw Ladder with Cutcompcosts flag on top

A few of our posts have gone viral over the last few weeks. Some of the viral posts were from 10 years ago. I use the term viral very loosely. A very specific blog expects only so much traffic. J&L is still trying to match the 100,000 daily views from 2013. That figure was not an anomaly.

I have written 99.9% of the articles that you see before you. Original content is better than paying someone to write it and then use my name on it. A few competitors pay for articles. We do not. We will not.

One question I receive often is where do I get the ideas for writing articles or for presentations/webinars? Actually, a good article exists already on the blank page. I am just filling in the required words. Many come from the comments I hear at conferences, meetings, talking with business allies, and so forth.

The only two artificial improvements I have made to the blog is to hire a cleanup person for the last two years to link articles, clean up the spacing, add pictures, fix the copyright info, etc. The other is the frustrating, but good Grammarly. I now run it on every article before publishing them. The $135 per year was worth it (I think). Yes, I broke down and bought the Pro Version.

If you think of any subjects – Workers Compensation centered – that need to be written on, please email me or use the Contact page on the website.

In closing, we do not sell any of our data to any company at any time. Yes, we do use Google tracking, but that only for knowing the number of hits we receive and what the person was searching for in the website. We have chosen not to track individual site visits. That sounds creepy and it is creepy.

Once again, a BIG THANKS for reading the articles and newsletter over the last 11 years. Hopefully, for the next 11 years, there will be a Cutcompcosts to receive good technical Workers ‘ Compensation information.