In Pennsylvania, if an insurer contends that a medical service, drug or device is unnecessary, it must resolve the dispute through a process called utilization review, where medical professionals decide if the request is reasonable. The Pennsylvania Supreme Court ruled …
In the past decade or so, the world has undergone tremendous technological transformation. For example, in 2008, only 139 million smartphones were sold, compared to 1.56 billion in 2018, according to Statista. In that same year, Uber didn’t exist yet …
As medical costs continue to rise, workers’ compensation payors are looking for methods to identify expenses that can be controlled and ways to handle claims more efficiently. According to a Lockton white paper, medical expenses are now averaging well over …
Creating a physician peer review panel is like solving a puzzle – it comes together only after reviewing the landscape, discerning what is important, and identifying what resources are available. As in most industries, a problem or opportunity in the …
The California Supreme Court on Thursday sided with employers in a fight over the right of workers to sue over treatment for injuries that occur on the job. Workers receiving medical care through the workers’ compensation insurance of their employer …
Medical expenses, now averaging well over 60 percent of average claims costs, according to a 2014 Lockton whitepaper, represent a significant impact on an employer’s workers’ compensation total cost of risk. This trend isn’t going away soon, as this average …
New data on the Independent Medical Review (IMR) process used to resolve California workers’ comp medical disputes show that IMR volume dipped for the first time ever in 2017, but the outcomes were unchanged as IMR physicians again upheld 91.2 …
While critics say utilization review (UR) in workers’ compensation claims is nothing more than a cost savings mechanism, an industry expert outlined its benefits recently. During a multimedia series, Inside Workers’ Comp, Todd Andrew of Genex, a medical managed care …
Inappropriate early use of Magnetic Resonance Imaging (MRI) to diagnose work-related lower back pain correlates with higher medical costs, unnecessary and ineffective procedures and prolonged disability, according to research conducted by the Liberty Mutual Research Institute for Safety. The most …