Convergent Announces Case Study with Community Medical Centers on Workers' Compensation Claim Reimbursement
The Special Investigations Department in Ohio's Bureau of Workers' Compensation is among them. During the unit's 20-year history, it has apprehended enough cheats to save the workers' compensation program an estimated $1.5 billion. That's a substantial chunk of change saved for Buckeye State businesses, which pay premiums to provide coverage for their employees. It also is money that helps to ensure workers injured on the job get help. Here are a few of the cases the SID has handled during the past couple of years: Yet SID investigators got tape of her walking around, using both her arms and legs. They also taped her using a wheelchair for a visit to the doctor, then getting out of it after she left. She was convicted of fraud and sentenced to a year in prison. The two were ordered to pay $173,332 in restitution.
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Police veteran fighting Ohio workers' comp fraud
29, 2013 photo, Rick Gregory, the new director of the Special Investigations Unit at the Ohio Bureau of Workers' Compensation, poses for a photo in his office in Columbus, Ohio. Gregory says it's not fair that people following workers' comp rules are penalized by those who don't. Photo: Andrew Welsh-Huggins In this Thursday, Aug. 29, 2013 photo, Rick Gregory, the new...
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"We reconcile the accounts--the volumes and the dollars that are sent and sent back--we monitor the cash collections and really that is all we do." Convergent handles all of the traditionally difficult tasks associated with workers' compensation follow-up. Working directly from Community's HIS system, the national revenue cycle management firm used its own technology to calculate the expected reimbursement based on California's complex fee schedules, comparing actual payments and identifying underpaid claims. Whenever an underpayment is identified, Convergent provides the appropriate follow-up through phone calls, letters, and litigation if necessary. "Our success at partnering with top performing providers is founded on our ability to quickly and effectively increase reimbursement for healthcare services with the appropriate resources and adherence to regulatory requirements," said Derek Pickell, CEO of Convergent Revenue Cycle Management. Founded in 1992, Convergent's healthcare division serves hundreds of hospitals and healthcare providers across the nation. Their regulatory expertise and patient-focused contact center technology optimize revenue cycle performance, enhances the patient experience, and improves provider relationships. To access the case study, visit www.convergentusa.com/library. About Convergent Revenue Cycle Management, Inc. Convergent Revenue Cycle Management is recognized as the premier niche revenue cycle management company in healthcare, providing innovative solutions across the revenue cycle spectrum including patient access solutions, early out self-pay collections, attorney-powered third party reimbursement and bad debt recovery (through Convergent Healthcare Recoveries, Inc.).
For the original version including any supplementary images or video, visit http://www.marketwatch.com/story/convergent-announces-case-study-with-community-medical-centers-on-workers-compensation-claim-reimbursement-2013-09-05
projects that workers' compensation costs will see double-digit decreases in Oklahoma after state lawmakers passed a bill to do away with the state's workers' compensation court system. Oklahoma Senate President Pro Tem Brian Bingman and others who had advocated for a switch to an administrative workers' compensation system touted the loss cost reduction as a plus for businesses in the state. Workers' compensation costs are noted by employers of all sizes across the state as their top barrier to growth, which is why we passed comprehensive reform, Bingman said in a statement. Lower rates mean more money for investment, expansion, wage increases and job creation for businesses here, and a more competitive economic climate for companies looking to expand and relocate to Oklahoma. Most insurers will use projections on loss costs from the advisory group NCCI to set rates for workers' compensation insurance employers. The National Council predicts overall loss costs will drop 14.6 percent beginning Jan. 1. Oklahoma continues to be a leader by proving to the country that conservative pro-business policies lead to economic growth and prosperity, Oklahoma House Speaker T.W.
For the original version including any supplementary images or video, visit http://newsok.com/industry-group-projects-reduced-workers-comp-costs/article/3879764
Commission Keeps Claimant's Counsel and Recording Devices out of Employer's Medical Evaluations
submit to an examination by a physician or surgeon of the employers choice... which, the Commission noted, leaves the choice of EME physician exclusively with the employer. A Rule 35 medical evaluation, in contrast, may be ordered by a judge only on motion for good cause shown and upon notice... to all parties and shall specify the time, place, manner, conditions, and scope of the examination and the person or persons by whom it is to be made. The Commission also noted thatLangfeldt-Haaland was a 3-2 decision that explicitly limited its holding to Civil Rule 35 medical evaluations. The majority had argued the importance of allowing counsel to observe shortcomings and improprieties during the examination which could be the subject of inquiries on cross-examination at trial; and ... [to] object to questions posed to the plaintiff during the examination that concern privileged information. The dissenting judges pointed out that adopting such a rule could have a chilling effect on otherwise reputable physicians performing medical examinations. The Commission found the dissents position more persuasive, and also took into account a survey of SIME physicians that showed a significant percentage of the physicians surveyed would decline to perform evaluations if they were required to allow the evaluation to be witnessed and recorded.
For the original version including any supplementary images or video, visit http://www.workerscompensation.com/compnewsnetwork/mobile/workers-comp-blogwire/17415-commission-keeps-claimant-s-counsel-and-recording-devices-out-of-employer-s-medical-evaluations.html
Workers' compensation costs
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For the original version including any supplementary images or video, visit http://www.vcstar.com/news/2013/sep/05/workers-compensation-costs/
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