March 20, 2018

CA DWC Administrative Director Announces 2018 Profile Audit Review and Full Compliance Audit Performance

San Francisco, CA – Labor Code §§129 and 129.5 require the Audit and Enforcement Unit of the Division of Workers’ Compensation (DWC) to conduct a profile audit review (PAR) for all adjusting locations of California workers’ compensation claims at least once every five years. Performance of the adjusting locations is measured in five areas of claims administration: The payment of accrued and undisputed indemnity, the late first payment of temporary disability/first notice of salary continuation…[Continue Reading]

CLARA analytics Unveils Network Analysis Solution to Incorporate Case-Mix Adjusted Scoring into Network Stacks

Santa Clara, CA – CLARA analytics recently unveiled its latest product, Network Optimizer, at the National Workers’ Compensation and Disability Conference (NWCDC). Network Optimizer is an industry-first network analysis solution that incorporates case-mix adjusted scoring into a claims professional’s view of the network stack. This enables claims teams to instantly view physician scores while alerting them to quality, available doctors in a given specialty and closest geographical location to the injured…[Continue Reading]

Mitchell Survey: Over 45% of Industry Pros Believe Telemedicine Will Have Biggest Impact on Workers’ Comp in the Future

San Diego, CA – Mitchell recently coordinated with Risk & Insurance magazine to survey U.S. professionals in the workers’ compensation industry to gauge their views on which technologies they believe will have the greatest impact on the workers’ compensation industry in the future, and which operational areas will improve the most as a result of those technologies. Notably, 45 percent of respondents believe telemedicine will have the biggest impact on the industry, followed by artificial intelligence…[Continue Reading]

Sedgwick to Acquire Cunningham Lindsey

Memphis, TN – Sedgwick Claims Management Services, Inc., has announced that it signed an agreement to acquire Cunningham Lindsey, a global loss adjusting, claims management and risk solutions firm. An industry pioneer with 100 years of experience, Cunningham Lindsey assists businesses, insurance companies, brokers and policyholders around the world by offering expert support when losses occur, such as during natural disasters. The company’s 6,000 highly skilled professionals comprise…[Continue Reading]

2017 Workers’ Comp Benchmarking Study Releases Three-Year Industry Report Card for Claims Best Practices

Chicago, IL – Now in its fifth year, the 2017 Workers’ Compensation Benchmarking Study reprises its 2014 survey questions to measure industrywide advancement in claims management these past three years. The study also continues its potent method of validating how and what higher performers are doing differently than lower performing peers to reveal a more robust profile of the successful claims organization. Findings from the just published 2017 study reflect the responses of 572 claims leaders…[Continue Reading]

Travelers Launches New Digital Capability to Streamline Workers’ Comp Claims

Hartford, CT – The Travelers Companies, Inc. (NYSE: TRV) recently announced it has launched a new digital self-service capability that streamlines the workers compensation claim process. MyTravelers® for Injured Employees is a secure, web-based tool that provides injured employees with all the information they need to easily manage their claim from start to finish on their mobile device or computer. “We know that better outcomes are achieved when injured employees are closely engaged in their claims…[Continue Reading]

CA Division of Workers’ Compensation Suspends 12 Medical Providers

San Francisco, CA – The Division of Workers’ Compensation (DWC) has suspended 12 more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended this year to 85. Nine providers were suspended for fraud or criminal actions and three for administrative reasons. DWC Administrative Director George Parisotto issued suspension orders against the following providers: Paul Richard Randall of Orange, health care marketer…[Continue Reading]

Ametros Announces Growth Investment from Long Ridge Equity Partners

Wilmington, MA – Ametros Financial Corporation recently announced that it has received a growth capital investment from Long Ridge Equity Partners. The investment from Long Ridge will support Ametros’ continued growth and allow the Company to further enhance its world-class product and service offerings. Founded as an independent company in 2010, Ametros provides settlement recipients and self-pay individuals (its “members”) with a broad set of financial and medical management tools…[Continue Reading]

SFM Offers New Assistance Program for Injured Workers

Bloomington, MN – SFM recently announced that it is now offering an innovative service to help injured workers deal with struggles of everyday life they may be facing. The Injured Worker and Family Assistance Program is available to injured employees whose workers’ compensation claims are being handled by SFM, as well as their household members and dependents. A group of SFM claims representatives recommended creating the program after seeing injured workers struggle with a variety of personal…[Continue Reading]

New TDI-DWC Prosecution Unit Gets Indictments for Health Care Fraud

Austin, TX – A Travis County grand jury has indicted EME International, Inc. and three individuals on charges of engaging in organized criminal activity for overbilling for exams of injured employees. The indictment alleges fraud of between $20,000 and $100,000. The Texas Department of Insurance, Division of Workers’ Compensation’s (DWC) new prosecution unit obtained the indictments. The DWC prosecution unit is embedded in the Travis County District Attorney’s Office and was created…[Continue Reading]

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