Inside Workers' Comp

Workers' Comp Alternative Transitional Duty: A Win-Win for Employee, Employer and Community April 11, 2022 Statistics show the longer injured employees are out of work, the more difficult it is for them to return. But, what happens when injured employees aren't physically able to return to work right away? What can be done to help them stay engaged in work and their recovery, especially if there are no light duty options available in the workplace? Well today, Paul Bode, vice president, at Genex, joins us to explain a creative program designed to help injured employees engage in purposeful activity during recovery. It's called alternative transitional duty (ATD).

When an employee sustains a significant injury which requires inpatient care and rehabilitation, going home is often the first major goal of recovery. But the comforts of home may not be so comforting if the person requires a wheelchair or other assistive devices to get around. On today's Inside Workers' Comp, we talk with Nicole Usher of Apricus who explains how home modifications can make an injured employee's house home sweet home again.

In December 2020, an act was signed into law, which will change the way some reporting entities coordinate Medicare benefits. This PAID Act will go into effect before year's end, but CMS is busy preparing for the change. In today's podcast, Deborah Robinson-Stewart, joins us to explain.

There's a heightened awareness in our industry on how psychosocial factors impact an injured employee's recovery. But what's the best way to approach and address these issues? In the fourth and final installment of our mental health in comp podcast series, we ask Nikki Wilson and Tammy Bradly to share some best practices.

None of us have gone untouched by the COVID-19 pandemic. This is especially true for frontline workers who care for the critically ill. So, in part three of our series on mental health’s impact on workers’ comp, we’re going to look at the psychosocial effects the pandemic continues to play on our society and how post-traumatic stress disorder (PTSD) has become a term used more often in our industry. Joining me today are our experts, Nikki Wilson, Tammy Bradly, and Mariellen Blue.

Traditionally, the term mental health has been treated as a claims pariah in workers’ comp, as it’s been associated with delaying recovery and sending costs spiraling out of control. Yet, ignoring the reality that psychosocial factors exist in mostly all claims is perhaps the biggest cause for these problems. In part two of our mental health podcast series, we ask Tammy Bradly and Mariellen Blue if addressing mental health in the initial assessment and throughout the claim can actually have a positive effect on claims management.

Hello and welcome to the first of a four-part podcast compliment to the Mitchell | Genex | Coventry thought leadership eBook, Strategies for Combating Mental Health Challenges in Injured Employees. Over the course of the next few weeks, I’ll be joined by Mitchell | Genex | Coventry experts Mariellen Blue, National Director of Case Management Services at Genex, Tammy Bradly, Vice President, Clinical Production Development at Coventry, and Nikki Wilson, Director, Pharmacy Product Development at Mitchell, to dig deeper into the mental health issues covered in our eBook

Quality assurance is a vital part of any workers’ comp claim. No more so than in case management, where details and communication matter most. In today’s Inside Workers’ Comp, I’m joined by three Genex experts — Judy Speirs, Case Management Senior Product Manager, Linda Mastropaolo, Case Management Product Manager, and Linda Wolf, Case Management Senior Product Manager — to discuss how case managers ensure quality in their cases and why it’s so important to meet these objectives.

Over the last few years, New York has been implemented new reforms to increase the speed and efficiency of its claims process. In today’s Inside Workers' Comp, Dr. Lisa O'Connor, Genex's Associate Clinical Director, Utilization Review, tells us about one of them, OnBoard, New York’s new online web portal for processing workers’ comp claims.

2020 will go down as one of the most difficult years many of us have experienced. After living through months dominated by a pandemic, economic downturn, natural disasters and a divisive election, most of us can’t wait to turn the calendar on Jan. 1. As you sit down to a much smaller Thanksgiving table this week, will you struggle finding much to be thankful for this year? We asked that question to Genex’s Rich Leonardo, Dr. Lisa O’Connor and Mariana Diaz. Their answers may surprise you. Take a listen.

As employers are looking for efficient ways to keep work environments safe from COVID-19, Optis has developed Safe2Work, an app-enabled, web-based health screening program designed to help stop the spread of workplace illness. In today’s Inside Workers’ Comp, we talk with Bryan Stonecipher, president of Optis, and Jacob Sipko, vice president, at Genex Services, about how this program works.

Technology is playing a larger role in helping comp claims progress. In today’s Inside Workers’ Comp, Bobbie Doyle, director of utilization management at Genex, explains the ins and outs of a program designed to do just that. It’s called Referral Expert.

The independent medical exam (IME) is a valuable tool to move claims forward, unless your IME provider doesn’t have a strong quality assurance (QA) process. Even the slightest error can make a big difference in determining whether your report is considered valid. In today’s Inside Workers’ Comp, Donna Bradshaw, vice president of IME services at Genex, explains how to determine if your IME provider’s QA process is up to snuff.

It’s been two months since the World Health Organization declared COVID-19 a pandemic. Our world has changed in many ways since then, but one thing that hasn’t is Genex field case managers’ commitment to move claims forward. In today’s Inside Workers’ Comp, we talk to Tim Howard, Senior Vice President of field case management, to discuss how his team is operating under restrictions and how he sees the process evolving as states start to open up.

In today’s Inside Workers’ Comp, Leanne Bronold, clinical guidelines manager at Genex Services, informs us of her team’s development of such an important guidance tool.

Today, we think about the nurse case managers on the front lines, helping employees recover from injury and illness. Their determination to provide exceptional care goes beyond the physical injury and extends to improving the whole person. In one case, even with her state on lockdown due to coronavirus, Genex case manager Becky Almskog, RN, BSN, CCM, of Colorado faced a life-or-death dilemma — how to keep a homeless, at-risk injured employee off the streets and on the road to recovery.

In today’s world, payers need complete transparency into their IME program, from big picture to claims-level data. But how do you make that information easily digestible and current so it provides a true comprehensive view into IME program data? For Jim Harris, vice president of data and analytics, and his team at Genex, the answer was creating a dashboard which provides real-time metrics to help organizations manage costs and outcomes. Jim joins us today to talk about it.

Time was on the side of WCRI as it held its annual conference in Boston earlier this month just before coronavirus concerns reached pandemic levels. While handshakes and hugs were replaced with nods and elbow bumps, participants left the event with new insights on trends affecting the industry. Here to talk with us about it is Milann Dittman, senior data analyst at Genex Services.

In December, workers’ compensation lost one of its most talented reporters and influencers as Roberto Ceniceros announced his retirement. Roberto’s career in comp spanned a quarter century during which time he chronicled the changes of the industry as a writer for Business Insurance and Risk and Insurance and also served as chairman of the National Workers’ Comp and Disability Conference. We’re honored to have Roberto on today’s Inside Workers’ Comp to talk about the industry.

Everyone knows nurse case managers play a vital role in reducing costs of workers’ compensation claims by guiding the continuum of care for injured employees. And now some programs are implementing the same approach to help better manage the employee’s medication regimen. At Genex, these professionals are called pharmacy nurse champions, and Bobbie Doyle, director of utilization management, joins us today to explain how they’re making a difference in claims management.

In the second part of our exclusive interview with Peter Rousmaniere, he discusses how current trends will impact the future of the industry and leaves some parting advice onr how workers’ comp can continue to evolve with the times.

When you think of industry icons in workers’ comp, Peter Rousmaniere is among the select few at the top of the list. For more than 30 years, Peter has been a major influencer in workers’ comp, especially over the past couple of decades as a popular columnist. Last month, Peter announced his well-deserved retirement, so we asked him to join us on Inside Workers’ Comp to talk about his celebrated career and offer insights on the industry. The conversation was so profound that we made it into a two-parter. Here’s Part 1.

Thanksgiving is coming, which means it’s time for our favorite podcast of the year: What are You Thankful for in Workers’ Comp? This year, we invited three experts who share very different reasons why they are grateful for comp: Heart of Case Management Award winner Charlene Ramsey, RN, BSN, CCM; Helen Froehlich, vice president of case management; and Donna Bradshaw, vice president of IME Services. We hope their responses lead you to contemplate on your own unique role in workers’ comp and how YOU make a difference in the lives of others.

NWCDC is just days away. As you get ready to head back to Vegas, we asked Genex’s Ron Skrocki to give us a preview of what to expect at this year’s conference, including a session he’ll be presenting on Nov. 6 with Mitchell’s Michele Hibbert-Iacobacci and Rebecca Morgan.

What’s causing the rise of psych IMEs in workers’ comp? by Inside Workers' Comp

The success of a utilization review organization depends on the quality of its physician network. This starts with taking careful measures to verify the credibility of reviewers to ensure good outcomes and prevent fraud. In today’s Inside Workers’ Comp, Genex’s Dan Maldonado explains what good UROs look for in hiring the best physicians.

Post-Traumatic Stress Disorder can also have a strong impact on injured employees and delay return to work. Mariellen Blue, Genex national director of case management services, joins us to talk more about this issue in today’s Inside Workers’ Comp.

It’s been nearly three years since California passed Senate Bill 1160, a utilization review reform measure designed to accelerate and improve workers’ comp care for injured employees. While components of the law have been implemented, the final regulations have not yet gone into effect. Genex clinical director Dan Maldonado gives us an update on the process and what we can expect once the new regulations go into effect.

A good stay-at-work program can offer many benefits to employees and employers such as improving team morale and preventing a disability claim. However, establishing a successful plan can sometimes be a challenge. To help make this process easier, Genex disability and absence services experts Kevin Ufier and Linda Mastropaolo offer tips on how to develop a successful program.

Addiction in workers’ comp has been a hot-button topic over the past decade, mostly due to the staggering number of injured workers who have become addicted and, in the more tragic cases, have succumbed to prescription opioids. Yet, the same level of attention hasn’t been given to another addiction issue, treating those injured employees whose struggles with drugs and alcohol predate their injury.

WCRI’s recent annual conference delivered valuable research and insight on the current (and future) state of the industry. In today’s Inside Workers’ Comp, Genex’s Jim Harris shares three big takeaways from WCRI that could have the biggest impact on claims in the next few years.

In today’s Inside Workers’ Comp, Deborah Robinson-Stewart helps demystify the MSA and offers insight on when payers should incorporate this tool.

The speed, costs and reliability of diagnostic services can seriously impact the progression of a claim, especially if the exams are hampered by poor customer service. On today’s Inside Workers’ Comp, Bob Smith, CEO, of Priority Care Solutions, a division of Genex, explains why quality customer service is so important.

Technology is playing a larger role in workers’ compensation as durable medical equipment innovations are helping injured workers return to work at a faster rate. The problem is keeping up with what’s new and what’s necessary for expediating recovery. Bob Smith, CEO of Priority Care Solutions, a division of Genex Services, offers tips on how to get the most from your DME supplier in today’s Inside Workers’ Comp.

Light-duty options for injured temp staffing employees When most people think of light-duty return to work, staffing agency employees are often not considered.

Personalized Comp-the Starbucks Way by Inside Workers' Comp

Are You Thankful for Workers’ Comp? by Inside Workers' Comp

When there’s a return to work delay, practitioners often look for problems that occurred during the course of treatment.

The workers’ comp industry is always searching for new ways to increase safety in the workplace.

Staying on Top of Regulatory Changes in Bill Review by Inside Workers' Comp

Providers can significantly contribute to the success of a workers’ comp claim, so finding the best ones to assign to a case is key to positive outcomes.

Workers' compensation payers are under increasing pressure to consider and protect Medicare's interests when settling claims. In this edition of Inside Workers’ Comp, Deborah Robinson Stewart, National Manager of Medicare Services at Genex, breaks down the basics of MSAs and offers insight of when they should be established.

How to Handle a Disaster in Workers’ Comp by Inside Workers' Comp

There’s been a lot of talk about injured worker advocacy and empowerment in workers’ compensation. But what exactly does that mean? Genex’s 2017 Heart of Case Management Award winner Lisa Armstrong, BSN, CRRN, RN-BC, has a few ideas to keep your injured workers invested in their own recovery.

Case Management: Can Any Nurse Do It? by Inside Workers' Comp

Are You Thankful For Workers' Comp? by Inside Workers' Comp

Uncovering The Hidden Treasure In Your Bill Review Program

Genex’s Chikita Mann explains the ramifications of nursing state law restrictions and how they impact return-to-work and claim costs in our latest edition of Inside Workers’ Comp.

In today’s Inside Workers’ Comp, data analytics expert Jim Harris explains how factors such as aging claims systems and inconsistent data input could be preventing you from capturing, reporting, and trending the information you need to make important claims decisions.

Managing Catastrophic Cases: Best RTW Strategies for the Worst Workplace Injuries by Inside Workers' Comp

Who Will Fill the Void? Recruiting Younger Workers’ Comp Professionals by Inside Workers' Comp