Hazardous industry experts from the world’s largest organization for health and safety professionals have recently played a part in improving submarine safety, according to the Institution of Occupational Safety and Health.
(IOSH) Hazardous Industries Group (HIG) worked together with the Submarine Enterprise on a Peer Review, to improve the safety of submariners who work with nuclear energy, chemicals and other major hazards on a daily basis. (WCxKit)
The Peer Review Implementation Team made use of HIG’s experience of Peer Review to develop a process that helped enhance safety culture. Its aim was to further reduce risks to individuals and prevent the possible degradation of layers of protection upon which submarine safety depends.
This arose out of IOSH HIG’s overall peer review project, which is aimed at developing teams of professionals to go into each other’s companies and share best practices, helping to change and develop safety strategy.
Royal Navy Commander Mark Westwood and Dave Mason, IOSH HIG committee member, worked collaboratively to encourage the highest standards of safety across the Submarine Enterprise.
Mason, who is also a founding member of IOSH HIG Peer Review project, said, “The key to our Peer Review process is to define what excellence looks like, to engage leaders in ‘walking the talk,’ to observe what people really do and to identify an organization’s opportunity for strategic development of safety.
“Submariners have one of the most dangerous jobs in the world. So the fact that this process has been integrated into such a diverse and complex industry shows how flexible and powerful a tool it is.”
Mason was invited to work with the Submarine Enterprise to develop the Peer Review process, in a bid to help enhance its safety culture and maintain high standards of safety.(WCxKit)
The companies involved included Ministry of Defence (MoD) Defence Equipment and Support, Royal Navy – Navy Command, Atomic Weapons Establishment (AWE) Plc, Babcock Marine, Rolls Royce and BAE Systems Submarine Solutions – all of whom agreed to exchange information, encourage communication, and emulate each other’s best practices.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Few people realize the workers’ compensation industry is actually 100 years old. It’s one of the most-successful public-private partnerships in U.S. history.
Since 1983, the Workers Compensation Research Institute
(WCRI) has been providing the public with research on WC public policy issues. Based in Cambridge, Mass., the organization includes among its members employers, labor organizers, public and private insurers, health care providers, managed care companies, and state government representatives from the U.S., Canada, New Zealand, and Australia.
Dr. Richard Victor, WCRI executive director, oversees the institute’s studies and analysis that has added ammunition for the reforms to various aspects of the workers' comp system. Prior to working at the institute, he spent seven years conducting research at The Rand Corporation in Washington , D.C., and Santa Monica , Calif. His law degree and Ph.D. in economics is from the University of Michigan.
LowerWC recently asked Victor for his impressions of the industry. What follows are some of his comments:
“One of the most important, and troubling, areas for workers’ compensation systems is to find the appropriate ways to use narcotics – and to discourage abuse and diversion. A second critical issue is to find new and innovative ways for help workers return to productive employment,” Victor says.
To this end, WCRI is conducting several research phases to help find answers for WC narcotic use and return-to-work issues, he says.
Victor says the latest trends in workers’ compensation also include medical cost management. “Medical costs now represent more than half of workers’ compensation costs in most states. There is increasing focus on pharmaceutical costs and utilization and the payments made to hospitals and ambulatory surgery centers,” he says.
Further, everyone wants to know how to save the employers money. Victor says, “Most large employers are focused on three legs of the four-legged cost containment table – risk financing, injury prevention, and claim management. The fourth leg is a large opportunity because employers have underinvested in it – improving the ‘rules of the game’ to make the system more effective for workers and more cost effective for employers.”
He continues, “This requires that employers join together to formulate political positions and strategies and gather available evidence about how a given state system is performing, how it might be improved, and what lessons can be learned from other states.”
California and Texas are good examples of where employers have taken collective action and costs have fallen significantly, Victor says. One of the chief objectives of the WCRI CompScope benchmarking studies is to help stakeholders and public officials set priorities and debunk myths.
One important part of this research is an upcoming conference. The WCRI Annual Issues and Research Conference will be Nov. 16-17 in Boston with keynote speaker Peter Barth, professor of economics emeritus at the University of Connecticut. This will be its 28th year.
The goal there to present new ideas and alternative views, Victor says. “Whether you are managing workers’ compensation claims, involved in strategic planning, concerned with medical costs and utilization, or just looking for a better understanding of workers' compensation – this is the conference for you.”
All of the sessions highlight the first presentations of the latest research findings from WCRI while drawing upon the diverse perspectives of highly-respected workers’ compensation experts and policymakers from across the country, he says. “Attendees tell us that they value the large attendance because it allows them to leverage their time while at the conference. There are also opportunities to meet and interact with WCRI researchers.”
“The most important advice I can give remains a secret until the WCRI conference, when I (present) ‘The Elephant in the Room.’ It will highlight some things that are underappreciated, but are likely to shape workers’ compensation systems for the next decade. The future is not always like the past,” Victor says. “Of course, I would like to see your readers attend to stretch their thinking, gain a competitive edge, and network with peers.”
Author Rebecca Shafer
, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of Manage Your Workers Compensation: Reduce Costs 20-50% on cost containment techniques. www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Posted in
Assessment & Diagnostics,
California Workers Comp,
Communication with Employees,
Drug, Alcohol & Impairment Testing,
Employment Law Issues,
Federal Workers Compensation,
Implementation and Rolling Out Your Program,
Management Commitment,
Professional Development Issues,
Return to Work and Transitional Duty,
Seminars and Courses |
While more colleges are now offering majors in risk management and insurance than there were available just ten or twenty years ago, many of the people who come in to the field of risk management and the even more specialized field of Workers Compensation Manager, do not have previous experience or backgrounds in workers compensation. It is nothing unusual in this day of tight hiring practices and double duty jobs for the new workers comp manager to also be working in another department such as finance or human resources. It becomes a learn-as-you-go-experience.
We know the new workers comp manager, even the one who has been a workers comp adjuster, often needs a guide on what to anticipate in the new role. Therefore, we have put together a list of 10 things it helps to know about the job. Here is our list of ten things the new workers compensation manager knows, but no one will tell. (WCxKit)
1. The Safety Manager is your new best friend.
The better the safety manager does the job, the easier the new WC manager’s job will be, as fewer accidents means fewer workers compensation claims to be made. Ask the safety manager what can be done to eliminate accidents and injuries.
2. Learn how to read the loss run.
The loss run provides tons of useful information on the nature and the extent of the injuries. Learn about the types of injuries that occur most often and discuss with the Safety Manager what can be done to eliminate the frequent reoccurrences. Review the loss run to see how much money is being spent on medical and how much money is paid out in indemnity benefits. Look for areas where costs can be reduced. Customize the loss run; ask friends about the most helpful stats they have on their loss run, and include those on yours.
3. Know your insurer.
The insurance company that writes the workers compensation insurance is the insurer. The term “insurance carrier” will also be used. This does not mean they carry premiums to the bank. It is an old fashion term for carrying the burden of insurance loss. (Not to be confused with “insured” which is the employer). Learn about the insurer. Are they a mammoth insurance company who writes workers compensation as one of many types of insurance, or are they a smaller regional or local company that specializes in workers compensation. What services do they offer as part of you program or at low cost. Ask them to explain ALL of their services, not just those they pre-select.
4. Know the cost of workers compensation.
Learn what is paid for workers compensation insurance each year, and if the premium is paid monthly, quarterly, or annually. Learn policy dates and which way the premium has been trending in recent years. (Declining premiums are a good sign the safety manager is doing his job well, while increasing premiums indicates a need to team with the Safety Manager to reduce the number of claims and the severity of the claims that do occur. Know how to translate this into total dollars spent on workers compenstion and use this
calculator to gain managment support.
5. Timing is everything.
The most successful workers compensation managers are the ones that learn time is of the essence in almost everything done as a work comp manager. New injury? Report it immediately to the claims office and immediately advise the medical provider's office of the transitional duty program. New disability slip? Coordinate with the injured employee's supervisor on how to accommodate the light duty work slip. New information on an older claim? Call the adjuster and share it with her so she can act on the information while it is still beneficial.
6. Sometimes it is time to babysit.
Injuries do happen. The employee needs to know the company still cares after the worker is no longer able to work. If there is a workers compensation coordinator, you can delegate to her the job of keeping in touch with all the injured workers until they are back to work doing transitional duty. The best policy is to contact the injured employee after each medical appointment to learn of any issues with their medical treatment, their return to work status and any concerns they have about their job or their work comp claim. By showing the injured employees the employer cares, it will have an overall effect of lowering cost of workers compensation.
7. Know the adjuster(s).
The adjuster is now a new best friend. A competent adjuster who does the job well will make the WC manager’s job easier. The better the working relationship with the adjuster, the fewer snags encountered on workers compensation claims. (The fewer adjusters to work with, the easier it is to learn their strong points and weak points. If the claims are not already consolidated with the minimum number of adjusters possible to cover the claims, work toward consolidating claims with the best adjusters available.
8. Know your insurance broker.
The broker is now a third new best friend. A mistake a lot of new workers comp managers make is thinking the broker works for or is an employee of the insurance company. The broker is a knowledgeable business person who works for the employer as an advisor. The broker's main job is to keep the employer (insured) happy. Discuss with the broker what benefits are provided. Hold the broker to this, and the new job will get easier. Expect more than simply an annual stewardship report. Ask the broker to be proactive and make suggestions about your workers compensation program. Many brokers provide our
workers compensation manual to their clients at no charge, so make sure you get one from your broker if available, otherwise, purchase it directly from us.
9. Know the return to work program.
The better the company's transitional duty program, also known as modified duty or light duty, the quicker and faster the workers compensation claims will come to an end. The company is going to be paying the cost of the indemnity benefits through higher workers comp premiums. To reduce the cost of those benefits, return the employee to modified duty. While the injured employee may not be as productive as an uninjured employee, all the productivity of the injured employee on light duty is benefiting the company to some extent while reducing the cost of the claim. Use the
transitional duty calculator to demonstrate cost savings.
10. Review the claim files.
If asked, most third party administrators or insurance companies will arrange online access to the claim file notes where the adjuster records the activities and events of the claim. While the file notes are helpful, they do not tell the whole story. Go to the claims office and read everything in the claim files. The claims office will probably try to talk you into doing an on-line review, but an in-person review with the adjuster(s) about the claims will provide the most information. There are also claim consultants who do claim file audits, if that is preferable. (WCxKit)
Good luck in the new role as the work comp manager. Use the ideas and consult our website often for advice on workers compensation.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
The Roundtable is a discussion platform for employers, business owners, risk managers, HR managers, insurance executives, and brokers. Here they talk about the obstacles in managing workers compensation and learn strategies to overcome them.
Clicking on the links below not only brings you to the articles listed, but also gives you an opportunity to become a LinkedIn member. Or, click
here to sign up.
CERTIFIED MEDICARE SECONDARY PAY
The CMSP credential is an advanced program designed to be the most comprehensive, cost effective program teaching Medicare Secondary Payer Compliance. While the CMSP program includes in depth discussion of the Medicare Set Aside process, it teaches much more. Class to be taught in the Loews Hotel in New Orleans, LA on Sept. 26-28, 2011. (WCxKit)
Social Security Disability Insurance (SSDI) is intended to replace lost income for people suffering from a disability that is likely to cause substantial long-term losses in earnings. A concern has been that SSDI may have a disincentive effect on the willingness of recipients to work — that is, that some SSDI beneficiaries would work if they did not receive benefits, say Nicole Maestas and Kathleen J. Mullen of the RAND Corporation.
Laid-off workers and aging baby boomers are flooding Social Security's disability program with benefit claims, pushing the financially strapped system toward the brink of insolvency.
Read our members interesting answers.
Workers Compensation Roundtable is jointly managed by people dedicated to the concept that workers compensation is a manageable line on the employer’s expense ledger and informed professionals are empowered achievers. Workers compensation is not simply a cost of doing business; it is a cost that can be controlled. (WCxKit)
Beginning with an assessment of cost drivers, benchmarking data, and integrating the solutions, employers can reduce workers comp costs 20-50%. With proper information, professionals managing compensation claims can reduce costs and improve outcomes for all stakeholders in the process.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Work Comp Roundup attends the National Workers Compensation and Disability Conference® & Expo (NWCDC) at least every other year.
As seasoned conference goers, we offer some hints and tips on how to make the most out of our experience.
You might wonder why those already established in the industry attend still attend conferences…
The reason is that the workers compensation industry is always evolving – new players, new laws, and new equipment. We recommend everyone who is new to our field attend industry conferences often. This time of year, it's the National Workers Compensation and Disability Conference® in Las Vegas in November to learn what is new.
At Roundup, we always learn new techniques, meet new vendors, and discover the latest service enhancements. In fact, when I began, I learned this field from the ground up — NWCDC was a part of that education! 20 years ago, in Chicago — my, how time flies.
A conference of this scale can help you expand your knowledge and gain new solutions directly related to:
1.Workers compensation,
2.Disability management,
3.Return-to-work programs,
4.Better Claims Management,
5. Health/Medical Management,
6. Solving Legal/Regulatory Issues, and
7. Strategic Views
The National Workers Compensation and Disability Conference® & Expo Nov. 9-11 in Las Vegas is the nation's leading event for dedicated to the workers' comp and disability management industries. Hundreds of our colleagues gather each year to expand their knowledge and gain new solutions directly related to their workers' comp, disability, and return-to-work programs.
Celebrating its 20th anniversary, the conference offers more than 30 breakout sessions organized by type and level. Plus, there will be an in-depth pre-conference symposium, “Awesome New Technologies: What You Need to Know to Drive Improvement.” The Expo portion of the conference hosts more than 260 exhibitors providing an additional venue to gather knowledge to take home plus numerous opportunities to network and glean insights from top experts on how to solve your problems in claims management, strategic program planning, health/medical management, plus legal and regulatory issues.
As a seasoned conference goer and industry leader, here are ideas about how to get the most out of this large national conference:
Eleven Ways to Get the Most Out of the National Conference:
1. Attend the Opening Session. This is a large session for all attendees where awards are given to the best companies in the industry. Don't miss this because the award recipients will describe their programs, what works, what doesn't, how they overcame challenges specific to their industry and company, and likely the same obstacles YOU are also encountering. You will hear many ways to reduce costs, and you will take many notes.
2. Focus on your specific goals, for example, attend sessions about return to work programs or allocation systems, if you need to learn more about how to implement these cost containment techniques. I use my Program Planner like a lesson plan, circling the first and second choices.
3. Read the brochures you collect when you return home; use them as your own private educational program to LEARN what is available. How could you possibly request an off-site vendor be added to your list of service providers if you do not that such as service exists? You can't! How could you ask for nurse triage if you do not know the service exists? You can't.
4. Pass your business card out and do not be afraid to network – that is part of this business. Meeting knowledgeable people gives you a resource when you encounter a problem. Sitting at the round tables encourages discussion. Don't be afraid to tell people at your table you are new. They may be too, and if they are experienced, they'll be happy to help you. We've all been new at some point in our career.
5. Learn what you don’t know you don’t know. We often find employers who have misidentified the cause of their high work comp costs. They think it is nurse case management or bill review that is driving costs, when it is really poor management and operational practices. Being exposed to new ideas presents an opportunity to learn things you don’t even know you are missing!
6. Chat with people who do the same things that you do and see where you differ. One thing I like about the conference is that some of the most popular sessions are repeated at different times, and if I begin a session that does not interest me, or isn't applicable (which doesn't happen often), it is not a problem to quietly sit in another session down the hall. CAVEAT: Be courteous if you think you might do this as it's not fair to distract the speakers or other participants by being noisy or disruptive, so take care to come and go quietly, and sit in the back of the room near the door. Many sessions are very close in proximity to each other — in the same large hallway – which makes entering another session easy.
7. Learn Key Cost Drivers. Find people who work in workers compensation departments you know next to nothing about and ask them whether they are satisfied with their workers comp vendors. Ask them what drives their costs. We speak daily with companies unhappy with their TPA or insurance carrier, but are only guessing about what is driving their costs. If you are even thinking of changing carriers or TPAs, I suggest you attend the sessions at the conference to make sure you are on the right track.
8. Roam through the exhibit hall speaking to vendors and learning about the types of services that are available to reduce workers comp costs. THIS will be the best education you will ever get!
9. Wear comfortable attire. Bring comfortable shoes. I call my black flats my "conference shoes." You will be on your feet a lot, so be comfortable. The first day, people are a bit more dressed up than the following days. The last day is more casual because people are traveling back home. You will definitely want to dress professionally because some of the people you meet with become lifelong contacts, so making a good impression is important, but you can be comfortable, too. For an ounce of prevention, bring moleskin to protect the areas of your feet most likely to get blisters.
TIP: Visit the Exhibit Hall and the Educational Sessions. Attend both. Try to visit every single vendor in the exhibit hall. Start on the right, and move systematically through the rows.
TIP: Start early, leave late, and remember … although your feet may hurt, this is only once a year!
TIP: Before the Exhibit Hall opens, have breakfast in the Continental Breakfast Hall to network with new friends. You will find people are very friendly and helpful. I love the 8-round tables which make it so easy to introduce yourself to those at your table.
HINT: Bring band-aids – you will do a lot of walking, and you may get a blister or two, so come prepared.
10. It is affordable. If the CEO or business owner does not want to spend the money for you to attend the conference, show them the TRUE cost of your workers’ compensation losses with the Sales To Pay For Accidents Calculator to gain management commitment here: http://www.reduceyourworkerscomp.com/calculator.php.
For example, if you have just one $40,000 loss, it will take your company $666,666.00 in new sales to replace the $40,000 lost on that single claim. Learning how to reduce your costs is a wise business investment. It also makes you more valuable in the marketplace.
Yes, it is in Las Vegas, and if your CEO bemoans the fact that the conference is in a city more known for partying than workers’ compensation, let him or her know that Las Vegas is one of the most affordable travel destinations, which is undoubtedly one of the reasons the conference organizer chose that destination this year.
11. Keep your conference guide for future reference. You may want to have this handy on your desk for the time you want to try a new service or ask a question about a new service. Or, if you are putting out a Request For Proposal, this will be your ultimate list of those companies to bid on your project.
See you there!
Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation, and has attended the National Workers Compensation and Disability Conference® many times. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
So you want to pursue a career in the insurance industry? It is a good choice; the insurance world is essentially recession-proof and in times of poor economic performance, the insurance industry is booming! Or, maybe you are looking for a promotion or a little more security in the job you have.
When you think about it, everyone needs insurance, whether it is personal lines of insurance (auto, house, boat, etc.) or commercial lines (employer, work comp, premises, liability, etc.) everyone needs an insurance policy of some sort to protect their investments or their businesses.(WCxKit)
Requirements for getting into the claims adjusting field vary by carrier, but below we discuss seven items that are standard requirements. Already working in claims? Try to check off as many of these attributes as you can.
7 Must-Haves to Get (or Keep) a Job in the Insurance Industry
1. You usually need a college degree:
There was a time that a high school diploma would get you a job in claims. But times have changed, and to be considered for a career in claims you must have a bachelor’s degree in an insurance-related field, such as accounting, finance, economics, law enforcement, or human resources. If you can manage going back to school (on-line degrees are becoming easier and more legitimate), consider bumping up your education.
That is not to say if you have a degree in mathematics that you cannot get in, but if your studies included one of the disciplines listed above you have a better chance. Although some would argue with me, more often than not, carriers want someone who has zero experience in the industry. This way, people do not bring in bad habits learned at other carriers. Every carrier has a specific way of handling claims, and if they can train you from the ground up, it is seen as an asset, depending on the job position.
2. You have to have a good credit score:
Since you would be a fiduciary agent for your new employer, you need to carry a decent credit score. This will show your employer you take care of financial obligations in your personal life. Remember, you may be responsible for tens of thousands of dollars that are not yours. You have to represent the company at all times, whether you are working in the office or you are down at the courthouse trying to negotiate a file toward settlement.
The carrier will view your credit score as the way you handle your own financial obligations, and if you can show that you are responsible in your personal life, chances are you will act the same with their money as well. Already have a job? Remember your credit report may be just a Google search away from your boss’s fingertips – stay as clean as you can.
3. It helps to have law enforcement background:
Having a background as a police officer or some other work experience in law enforcement will help put you ahead of other applicants. These fields carry a certain degree of responsibility and investigational skills that transfer over to the insurance field.
Since you will be investigating every claim for compensability, being very experienced at doing detailed investigations is a great asset. Every claim you handle will need some degree of investigation. It also means you complete a thorough and detailed investigation. Investigation is probably the most important task because results deem if a claim will be paid. A particular claim may start as nothing major, but every claim has a chance to morph into a monster potentially worth hundreds of thousands of dollars. Being comfortable doing detailed investigations is something every carrier is looking for.
4. It helps to have a legal background:
Obviously work in claims carries the responsibility to read and interpret the legal system, sometimes in many jurisdictions at the same time. Having a law degree and/or prior work involving the legal system is another great asset you can have that will carry into the insurance field. Every claim will need to be deemed compensable or not, and the basis of your decision will depend on your investigation and how the injury or damage relates to legal statutes within the jurisdiction you are handling.
5. You should be organized and detailed:
Being a claims adjuster requires you to handle several issues at the same time. Every day you would have a list of things to accomplish on certain files. Additionally, you have to accomplish tasks in order of importance. I do not see many adjusters in the business who are not organized or have some system in place to handle files. A typical adjuster has about 150 files, sometimes more, and all of those files are at different stages in the claim. If you are organized and detailed, you will survive. If you are unorganized and do not have a system in place, you will drown in a sea of paperwork, phone calls, and emails.
6. You must pursue an insurance or adjuster’s license
All carriers require you to either be licensed or to secure a claims adjuster license within the first 90 days of hire. This is a comprehensive, state-administered, pass-or-fail test. The test can be quite daunting; especially to those with no experience, but with some studying and hard work it is achievable. Carriers provide you with study materials, and will give you a few tries. Securing your license is a must. If you do not already have one you should plan on getting one as soon as possible as part of your new-hire process.
7. You have to know or pass a HIPAA compliance test
HIPPA stands for the “Health Insurance Portability and Accountability Act of 1996.” Since you will be dealing with medical records, social security numbers, and other personal identifiers, every carrier requires you to pass a HIPPA compliance test. You have to be able to be trusted with your claimants’ personal information. Handling and disposal of those records is very important. Carriers can face fines and penalties if they are caught violating the HIPPA terms, and they are constantly educating you in proper ways to handle personal information. You should be aware of HIPAA, and the overall guidelines contained within before starting work with a carrier.(WCxKit)
In conclusion, a career in the insurance world is very rewarding, and job security within this industry is like no other. With some hard work, organization, and studying there is no doubt you will succeed.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) will present a series of free, half-day educational seminars titled Pharmacy Closed Formulary and Clean Claims/eBill. The seminars are being offered in cooperation with Small Business Development Centers.
The Pharmacy Closed Formulary portion of the seminar will provide an overview of the pharmacy closed formulary rules adopted by the TDI-DWC in December 2010 for both certified network and non-network workers’ compensation claims with dates of injury on or after Sept. 1, 2011.
The Clean Claims/eBill portion of the seminar will provide an overview of the new TDI-DWC requirements related to submitting paper and electronic medical bills, including a discussion of the changes from the previous requirements and a brief introduction to the new electronic medical billing standards. This presentation also provides an opportunity for new and experienced medical billing employees to recognize how to complete medical bills to minimize insurance carrier returns or rejections after the Aug. 1, 2011 effective date.(WCxKit)
House bill 528, which becomes effective June 17, can be found
here.
Among some the regulations in the bill include:
1. Insurance carriers must reimburse health care providers in accordance with the TDI-DWC’s pharmacy fee guideline or at a contracted rate.
2. Insurance carriers may also reimburse health care providers for pharmaceutical services at rates inconsistent with the TDI-DWC’s pharmacy fee guideline if the carrier has a contract with that health care provider that includes a specific fee schedule.
3. Insurance carriers or their authorized agents may use a pharmacy informal or voluntary network to obtain these contractual agreements with health care providers. If an insurance carrier chooses to use a pharmacy informal or voluntary network, there must be: a contractual arrangement between the insurance carrier or its agent and the pharmacy informal or voluntary network authorizing the network to contract with health care providers for pharmaceuticals on the insurance carrier’s behalf; and a contract between the network and the health care providers that includes a specific fee schedule and complies with the health care provider notice requirements of Texas Labor code.
4. The carrier must notify each health care provider, at least quarterly of any person, other than the injured employee, to which the network’s contractual fee arrangements with the health care providers are sold, leased, transferred or conveyed.
5. Each informal or voluntary network that has contracts in effect on June 17, 2011, must report the information listed in the labor code by July 17, 2011.
6. Failure for a pharmacy informal or voluntary network to comply with the registration requirements will result in an administrative violation.
Details of these new requirements will be explained at the conference.
Due to limited space, registration is required. For more details on the following educational seminars, visit the TDI-DWC Events and Training Calendar at
www.tdi.state.tx.us/wc/events/index.html. Pharmacy Closed Formulary will be presented from 8 a.m. to 11 a.m. and Clean Claims/eBill will be presented from 11 a.m. to 12 p.m. at each venue. Texas workers’ compensation system participants may attend one or both portions of the seminar.
Training Dates
Date City
May 6, 2011 Dallas
May 7, 2011 Fort Worth
May 20, 2011 San Antonio
May 25, 2011 Wichita Falls
June 3, 2011 Corpus Christi
June 8, 2011 San Antonio
June 10, 2011 Houston
June 24, 2011 Edinburg
July 15, 2011 El Paso
Aug. 18, 2011 Austin
This information was provided by attorney
Stuart Colburn, a Shareholder at Downs Stanford in Austin, Texas. Colburn has extensive experience in all phases of dispute resolution before the Texas Department of Insurance, Division of Workers Compensation and in district courts across the state. Stuart represents clients regarding workers compensation, non-subscription, subrogation, and bad faith litigation. He is the founder and the first chairman of the State Bar of Texas (SBOT) Workers Compensation Section; course coordinator for the SBOT the Advanced Workers Compensation Seminar; and course coordinator for the Texas Workers Compensation Forum. He can be reached at:
scolburn@downsstanford.com
WorkCover New South Wales (Australia) recently announced the 47 recipients of the $6.7 million WorkCover Assist Grants Program to help employers, unions and not-for-profit group training organizations prepare for the new national harmonization of work health and safety legislation.
In total 24 employer associations were awarded $3.1 million, 14 employee representatives were awarded $2.1 million, and four not-for-profit group training providers were awarded funding worth $344,552. In addition, four employer associations and one employee representative received high risk focus area grants worth $393,487. (WCxKit)
WorkCover CEO Lisa Hunt said NSW represented around a third of all business activity in Australia and with more than 3.2 million workers in the state, the changes to work health and safety laws would affect a large number of people.
“It is important employers, employees and other stakeholders are ready for its implementation and I’m pleased to announce the 47 recipients of the WorkCover Assist grants,” Hunt said. “There were a significant number of applications for these grants. This demonstrates the interest in the national harmonization legislation and I’m pleased so many have been successful.
Hunt continued, “The harmonization of WHS legislation will reduce compliance costs and regulatory burden for employers and enable workers holding licenses to work across jurisdictions more easily.
“It will provide consistency in safe work standards across Australia and allow the states and territories to share resources and information more freely, leading to even safer workplaces.
“These grants will support not-for-profit group training organizations, employer associations and trade unions implement a range of programs to prepare for the changes.
“These programs will be rolled out across the next 18 months and will fund educational programs that will focus on what the changes will include, and what people need to know to meet the requirements of the new legislation.” (WCxKit)
These will include:
1. Workshops and webinars for the retail industry
2. Training courses, including facts sheets for manufacturing industry apprentices
3. Educational site visits for small businesses like garden nurseries
4. Direct mail-outs, publications and telephone training for stakeholders in the
agriculture industry.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact:Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Finding a way to press on with accident and ill health prevention during difficult economic times is the theme this year of Scotland’s foremost safety event. In 2009-10 there were 23 worker fatalities, 2,548 reported major injuries to employees, and 7,992 over three day injuries to employees reported in Scotland.
According to the Royal Society for the Prevention of Accidents (RoSPA), everyday accident and ill-health issues facing firms will be thoroughly investigated at the RoSPA Scotland Safety and Health Forum, taking place at the Hilton Glasgow Hotel on September 21, 2011. The event is an evolution of the popular RoSPA Scotland Occupational Safety and Health at Work Congress and the title reflects a more dynamic learning experience. For more information visit: www.rospa.com/events/scotlandforum. (WcxKit)
Delegates at the forum will explore current and future health and safety issues in the wider context of budget cuts by getting involved with interactive workshops, discussion groups, and panel interviews — learning from each other as well as experts.
Chaired by Tom Mullarkey, RoSPA's chief executive, the conference is expected to attract a range of top safety stakeholders, including company directors, senior managers, health and safety advisers, and human resource professionals.
The event opens with a panel of experts taking part in a discussion entitled “A Day in the Life of Health and Safety: Overcoming Your Operational Challenges,” expected to provide solutions to real issues raised by delegates.
A variety of workshops covering safety leadership, communication, and health and wellbeing will take place, with plenty of top tips and practical advice given by prominent Scottish health and safety professionals.(WcxKit)
Two case studies will enable delegates to take away practical advice from the real world of business. One focuses on finding opportunities amid budget cuts. The second reviews a genuine accident autopsy, looking at how it happened, and what it really cost.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
One of the scariest parts of expanding a business into a new state for the self-insured employer is learning the workers compensation laws and state mandates in the way of forms, filings, hearings, etc. While an employer can hire a third party administrator (TPA) to handle claims, or a law firm to guide you through all the steps of workers comp claims handling, it is in your best interest to learn the basics of the workers comp system in the new state quickly. Or, get a good resource that has such information. Ask your TPA what resources they use. Even though they have professional resources, similar resources can be very helpful for the self-insured company.
Self-insured employers have two choices: spend weeks/months learning the new workers comp system or, to borrow a video game phrase, get “cheat sheets” to speed up the learning process. (WCxKit)
Many law firms specializing in insurance defense work sometimes offer “cheat sheets” to new adjusters and potential new clients as a way of building business. Instead of the employer spending “forever” learning the basics of the new state’s workers comp law, the cheat sheets give a synopsis of important information the self-insured employer needs to know.
If you want a jump of learning this information and don't want to rely on free cheat sheets, excellent information – in easy to use tables – is available from
www.workcompresearch.com.
Common cheat sheets/reference tools include:
1. A list or a table of state forms and when each is to be filed.
2. Explanations of state forms and rules associated with each form.
3. Table of temporary total indemnity benefits by calendar or fiscal year.
4. Table of temporary partial indemnity benefits by calendar or fiscal year.
5. Table of permanent partial disability benefits.
6. Table of scheduled injuries.
7. Charts for combining two or more
impairment ratings.
8. Death benefit tables.
9. Table on statutes of limitations on filing claim, appealing claims, etc
10. Calculation of indemnity benefit guidelines.
11. Checklist of defenses to claims.
12. Charts or tables on how the judicial system works.
13. Claim settlement guidelines.
14. Guidelines on the selection of medical providers.
15. Guidelines on posting a panel of physicians
16. Forms for:
· New employees/transferred employees to sign acknowledging the selection of a physician.
· Injured employees to acknowledge the attending physician requirement(s).
· Requesting a new physician.
· Employee to decline medical treatment.
17. Samples of required state notices for posting.
18. Recent changes in the state law.
In addition to the cheat sheets, get a glossary of workers compensation jargon and terms as used in a particular state. This type of glossary also assists you in understanding the abbreviations often used within the state, for example – DOAH (Florida Division of Administrative Hearings), BRC – Benefits Review Conference, or IW – injured worker. (WCxKit)
Summary
A new employer in a state can spend time learning the workers comp system, contact some of the law firms specializing in insurance defense work or consider
www.WorkCompResearch.com as eventually learning the system in the new state definitely has it benefits, but
quickly learning the basics summarized by experts speeds up the learning curve and assists in understanding the workers comp system.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
