San Diego, CA – Mitchell | Genex, a leader in technology solutions, medical cost containment, and disability management has announced its acquisition of CompAlliance, an established provider of managed care services, including its Preferred Provider Organization (PPO), Medical Bill Review, Case Management, Utilization Review, and 24-hour Nurse Triage. Financial Terms were not disclosed. With this… [Read more]
Claims, Legal, & Compliance News
Judge Sentences TX Businessman to Federal Prison for Health Care Fraud Scheme
San Antonio, TX – A federal judge recently sentenced San Antonio businessman Rafael Enrique Rodriguez to seven (7) years in federal prison for his role in a multi-million-dollar health care fraud scheme. In addition to the prison term, Senior U.S. District Judge David A. Ezra ordered that Rodriguez pay $6,032,126.69 in restitution to the government… [Read more]
Safety National Webinar: You Have Predictive Analytics – Now What?
St. Louis, MO – Safety National recently announced a new complimentary webinar, noting that predictive analytics have quickly become a necessary tool for effectively managing workers’ compensation programs, however, they do not produce cost savings on their own. They are merely a first step to a larger workers’ compensation claims management strategy. In the webinar… [Read more]
Ametros Establishes Regulatory Advisory Council
Wilmington, MA -(BusinessWire)- Ametros recently announced that it has established an expert Regulatory Advisory Council led by the company’s Senior Managing Director, Paul Sighinolfi, and chaired by its CFO, Nicole Sauk. The Council monitors and analyzes proposed changes to the Medicare Secondary Payer statute, workers’ compensation rules, and healthcare regulations. Given the important interaction that… [Read more]
CA DWC Posts Reminder for Submission of Annual Report of Inventory for 2019 Claims
San Francisco, CA – The California Division of Workers’ Compensation recently issued a reminder to claims administrators that the annual report of inventory (ARI) must be submitted in early 2020 for claims reported in calendar year 2019. The California Code of Regulations, title 8, Section 10104 requires claims administrators to file, by April 1 of… [Read more]
Sedgwick Launches New Crisis Care Program to Enhance Field Case Management Services
Memphis, TN – Sedgwick recently announced the launch of their new crisis care program as an enhancement to their field case management services. The crisis care program will provide 24/7/365 support and end-to-end resources to manage all aspects of care following a violent workplace event, catastrophic incident or complex clinical situation. Following these crises or… [Read more]
Data Dimensions Introduces Agnostic, End-to-End Medical Bill Processing Platform
Janesville, WI – Data Dimensions recently announced the launch of their newest offering, PANOPTIC, a 360-degree processing platform built for the auto casualty and work comp markets. PANOPTIC by Data Dimensions, is the first truly complete, end-to-end processing platform for the auto casualty and workers compensation industries. The platform is completely agnostic, integrating with any… [Read more]
JMS Consulting Announces Expansion of Services to Include Medical Bill Review
Conway, AR – JMS Consulting, a managed care cost containment company focused on Arkansas and the surrounding marketplace recently announced expansion of its capabilities to include medical bill review services. JMS noted that the addition of bill review is a natural extension of the significant clinical expertise the company currently offers, including its well established… [Read more]
CWCI Study Shows 94.1% Approval Rate for CA Workers’ Comp Treatment Services
Oakland, CA – A new California Workers’ Compensation Institute (CWCI) study shows that following the adoption of recent changes that streamline the California workers’ compensation medical review and approval process, 94.1% of medical services performed or requested for California injured workers were either approved (92.5%) or approved with modifications (1.6%). The study measures medical service… [Read more]
Riskonnect Launches New Workers’ Compensation Claims Benchmarking Model
Atlanta, GA – Riskonnect recently announced Riskonnect ClearSight 19.1, the latest version of its integrated risk management platform. The update delivers several enhancements that better inform risk professionals on how they’re performing from a claims management perspective. This insight drives better risk management practices and business outcomes. The new workers’ compensation benchmarking model enables companies… [Read more]