Leaders Speak

By Christopher P. Scoma PT, DPT, OCS, COMT National Product Leader – Physical Medicine, One Call Despite every safeguard, training program, and investment in prevention, workplace injuries happen. That reality isn’t a failure of effort – it’s the reason workers’ compensation exists in the first place. But what separates a system that serves everyone from… [Read more]

The Timeline from Potentially Traumatic Event to PTSD Should Drive Claims Strategy By Dr. Miranda Kofeldt, Vice President, Clinical Operations, Ascellus Behavioral Health Depending on the source, the average wait for a first mental healthcare appointment varies, but you’d be hard pressed to find a nationally relevant (and accurate) timeline of less than 30 days Other… [Read more]

By Nancy Schaefer, VP Sales and Customer Activation, Ascellus Risk stratification is not new in workers’ compensation. Carriers and payers have used it for years to route claims: flagging catastrophic injuries, watching for red-flag diagnoses, triggering nurse case management. What that infrastructure typically sees is physical risk: injury severity, body part, surgical versus non-surgical. What it… [Read more]

By Shannon Ford, MA, CRC, Senior Vice President, Case Management Solutions, Paradigm A lot can happen in the first 30 days of a claim. The lag time between the time of injury and when an injured worker receives active case management can span many weeks, and often it can be much longer. The days immediately… [Read more]

By Jeff Ziblut, Vice President, Post-Acute Care Services at Paradigm Recovery journeys for injured workers are rarely a straight line. Instead, they include twists, turns, and multiple waypoints before reaching their intended destination. Coming back from a workplace injury, especially a severe or catastrophic one, is complex, evolving, and deeply influenced by the decisions made… [Read more]

By Julie Black, RPh, Director, Product Development, MyMatrixx® by Evernorth Hippocrates once said, “It is more important to treat the patient and not the disease the patient has.” In Part 1 of this article, I described the need for and benefits of whole person health in workers’ compensation claims  and the concept of caring for… [Read more]

By Julie Black, RPh, Director, Product Development, MyMatrixx® by Evernorth In workers’ compensation, we need to treat patients as they come to us. But what does that mean? Ten or 20 years ago, workers’ compensation claims focused solely on treating a patient’s work-related injury – for example, a broken ankle. Today, workers’ compensation claims are… [Read more]

By Matt Sekula, Vice President, Workers’ Compensation Claims Strategy & Operations, Safety National Access to timely, appropriate medical care has become one of the most important issues shaping outcomes for injured workers. The issue has become more complex as provider availability, hospital closures, rural geography, specialty care access, and delivery models continue to shift. While… [Read more]

By Mark Walls, Chief Marketing Officer at Safety National Integrity. This is one of the most essential elements for any professional. To me, this means being honest, candid, and following through on your promises. On a recent trip, I was reminded of the importance of this. Our flight delays started at 9 am. Every hour… [Read more]

By Daniel M. Anders, Esq. Chief Compliance Officer, Tower MSA Partners The first article in this series examined the metrics that give payers a more disciplined view of MSP program performance—turnaround time, development letter frequency, counter-higher, approval variance, and clinical outcome measures among them. Measurement, however, is only the starting point. Once an organization can… [Read more]