Know These 5 Ways to Keep the TPA Relationship Running on all Cylinders

Whether your carrier/TPA is a small firm in your state, or a larger nationwide facility located on the opposite coast of the US, you will always have to have some sort of interaction with them. 

Claims will never be avoided, and since you are the employer, risk manager, claims coordinator, whatever your title may be, you need to know who to reach out to with questions. If the only source of contact with your carrier/TPA is a 1-800 number to call with questions, you probably will not get very far. You may eventually get to the right person, but it could take you all morning. 

 
 
To avoid such a scenario, you need to know who is handling your claim, where they are located, and how they can help you. The more you personalize your relationship with them, the better they will work for you, and the quicker your questions will be responded to.   Even if you only have a handful of claims per year, adjusters will respond to those employers they have a good interpersonal relationship with. Let’s discuss 5 ways to improve your relationship with your adjusting team: (WCxKit)
 

1.    Know your adjuster and their team

If you do not have a lot of claims per year, or you are a smaller shop with limited exposure, you may not really know which carrier/TPA office location will be handling your claims. Maybe they start off in one city, such as Boston, then end up in Philly. Or maybe they start off and end in Milwaukee. Do you really know who has your claims, where they are, and who to contact with questions?
 
 
If you call your agent/broker, they may have the answer to this question. But with insurance carrier/TPA offices becoming more and more consolidated, even your Agent may not be 100% sure. So reach out to your carrier/TPA and find out if a dedicated local office will be handling your claims. Or, maybe they will start out at their Home Office in Boston, and then be transferred out to a local office in your state if it is a lost time claim, a claim that needs special investigation, or a claim that has issues with compensability. If you know who to call or email with questions, it will make filing claims and getting answers to your questions that much easier and quicker.
 
 
2.    Communication is key
The main reason a claim derails from running smoothly is a lack of communication. Whether it is from the employee not talking to the adjuster, or a miscommunication between the employer and the adjuster, communication is extremely important when dealing with any aspect of claim handling. Be sure to check with your adjuster on all your open claims, and get an update on what is going on, and what their plan is to resolve the claim.  
 
 
Even if you only have a handful of claims per year, your input is valued more than any other. After all, you as the employer are their client, and the carrier/TPA wants to make you happy. Adjusters will appreciate someone out there that cares about what they are doing to move these claims along. Scheduling regular claim updates is also a great way to prevent a claim from slipping through the cracks. Plus the more you as the employer are involved, the more the adjuster knows they have to keep an eye on your claims since you will be checking up on them. The more you are involved, and the more you communicate, the better your claim will be handled.
 
 
3.    Answer all questions the adjuster asks
If an adjuster has a question about something, no matter how insignificant it may seem to you, it is probably really important to the adjuster. Several states require reporting to the State Bureaus of Work Comp, and missing information will hold an adjuster up from completing their filings. Even minor missing info such as a date of hire is important to the adjuster. They need complete info as part of their job for their state filings, so if they have questions about personal info, phone numbers, hire dates, wage history, etc. do what you can to get that info for them so they can move on with the claim. 
 
 
Details such as the hire date could also key them in on certain aspects of the claim. If it is a new hire, maybe that explains why a worker cut their hand, or strained their back. Wage info is always needed when there is lost time. If the adjuster needs the wages, they probably can’t pay your worker until they get that info. A date of birth is needed for state filings, but it is another key to the claim, since an older worker may mean that this particular claim won’t resolve as easily as it would with a younger worker. The examples here are endless, and the bottom line is to get any requested info to your adjuster on a timely basis. You don’t have to stop what you are doing to look that info up, but try to get it for them within a few business days. The sooner you do, the quicker it is off your desk and the less chance you have of forgetting about it.
 
 
4.    Bring your adjuster and their team out for a tour of your facility
If you are a large enough employer to churn out 50 claims per year, you probably will know who your adjuster is by name. You may even know who their manager is by name. But do you actually know who they are, other than just by name? Employers that have a lot of claims may know a little about their adjusters through casual conversation, such as if they are married and have kids, if they are sports fans, etc. 
 
 
A way to strengthen the relationship is to have them come out to your facility for a tour. Not only can you put a face to a name, but it greatly helps your adjusters by seeing the premises. Adjusters can look at the machines, observe the workers doing their jobs, and get a better idea and understanding of what you guys do day in and day out. This helps them mentally process the claim by knowing what your injured workers are talking about when they are describing what they were doing when they were injured. If you describe a machine injury to 10 people, you could get 10 different ideas of what happened. But if you show your claims team the machines and how your operators run them, and then they know exactly what a worker is talking about when they were injured.
 
 
5.    A “Thank you” goes a long way
As we have said time and time again, the work of a claims adjuster is often a very thankless job. Sure, it is the adjuster’s job to handle these claims, but often it is a stressful, high demand profession. Taking the time to thank your adjuster for their hard work will mean a lot to them, and they will take that compliment and use it to handle any of your issues right away. Your adjuster certainly will not forget your praise, and you can get them to work that much harder for you now and in the future. (WCxKit)

 

Summary:  
Even if you only have a few claims per year, you will want those claims to be handled as if you are the only client that adjuster works for. Unfortunately, this is not the case. Adjusters usually have 150+ claims they are keeping an eye on, and a good way to get yours handled effectively is by implementing what we have described above. Get to know your team, take the time to meet them in person and show them around, and hand out praise when it is deserved. Your adjusting team will not forget it, and it will only make your life that much easier when it comes to getting claims resolved.
 

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. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com. Contact: RShafer@ReduceYourWorkersComp.com.
 
 
Our WORKERS COMP BOOK:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php

 
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

5 Common Sense Actions Create a Great Safety Plan

 

pic1Safety Action Plan provides a guideline for your company to identify, manage, and monitor safety hazards posing a risk to your employees. According to the National Safety Council, 85 percent of all accidents could be prevented or reduced by having an effective safety program. To reach a high level of safety effectiveness a safety action plan is required. By creating a safety action plan, you remove the potential hazards and take the necessary actions to eliminate the hazards.

 

 

 

 

  1. Hazard Identification

There are various types of hazards. Many will be recognized by the safety manager, but even  safety professionals do not recognize all hazards. The loss runs produced by your insurer or third party administrator is an excellent source to identify hazards that you might not think about and overlook.

 

 

All company personnel should be encouraged to report any hazards they identify that have not been addressed by the safety manager. There are various types of hazards including:

  1. Physical hazards – machinery without guards, tow motors without back up sound warnings, inventory stacked haphazardly or too high, tools or equipment left where an employee could trip, etc.
  2. Ergonomic hazards – equipment or machinery placed incorrectly whether too high, too low, out of comfortable reach; processes that require the employee to twist back and forth; or that cause constant repetitive motions by the employee.
  3. Chemical hazards – improper ventilation, vapors from chemical processes, improper use of combustible materials.
  4. 4.  Biological hazards – in the medical field the improper disposal of needles and medical waste.

 

 

  1. Responsibility

The employer should treat safety as everyone’s responsibility. The employer should go a step further and hold the department supervisor or manager responsible for identifying the hazards within their work area. The department manager should be given authority to take the necessary actions to eliminate the hazards within the area of responsibility.

 

 

  1. A Course of Action

It is not enough to identify the potential hazards and to give the department manager the responsibility of correcting the hazard. The department manager must follow through and create an action plan to deal with the hazard. Some hazards can be fixed rather easily. For example, an action plan for the haphazard stacked inventory – unstack the inventory and stack it correctly. Other hazards will take planning and resources.

 

For example, the worn-out conveyor belt that poses a snag hazard for the employees. The hazard needs to be reviewed with the safety manager and a plan to remove the hazard should agreed upon

 

 

  1. Implementation

Whatever the nature of the hazard, once it is identified, timely and appropriate action to remove the hazard is required. When a course of action can be implemented immediately, it should be. When the course of action has several steps, the implementation should be scheduled with a completion date set for each step to be implemented. The implementation and completion of the necessary course of action will reduce the risk of injury to the employees and reduce the company’s exposure to financial loss.

 

 

When hazard correction entails the use of financial resources, management must take the appropriate action to provide the resources. When employees see management taking action and giving safety priority, the employees themselves will place a higher priority on safety.(WCxKit)

 

 

  1. Follow up

When a hazard is identified within one location within the company, the safety manager should check to see if the same hazard exists at other locations within the company. When the hazard exists at multiple locations, the hazard should be identified to all employees. The action plan and implementation of the action to remove the hazard should be completed.

 

 

Create a list of potential hazards. This can be very helpful in the elimination of future hazards. The list of hazards can become the foundation of a safety inspection checklist.(WCxKit)

 

 

A safety action plan is not a one time occurrence, but an on-going process to prevent new hazards from developing and to prevent old hazards from returning. By having a safety action plan, you can reduce both your physical losses and your cost of 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.

 

 

Our WORKERS COMP BOOK:  www.WCManual.com

 

 

WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php

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WC GROUP:   www.linkedin.com/groups?homeNewMember=&gid=1922050/

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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.

 

Try This Easy Fix Workers Compensation Cost Driver

A very easy  cost driver to fix is employee communication. Think of it this way: someone is communicating with your employees. They get messages from newspapers, television, billboards, and placards. OR  from a frequently played daytime ad for an injury attorney, encouraging them to sue.

 

It’s just not true talking about the ins and outs of workers’ comp encourages employees to file claims. In fact, the employer’s workers’ comp costs are lower the more a company communicates with their injured employees.

 

Communication  is part of an employer’s multi-level strategy of communication with everyone –employees, doctors, TPA, and broker. It may include video messages from the president, sample weekly meeting guidelines for workers’ comp coordinators to use, and forms for injured employees to complete.

 

In a workers’ comp program, you will “get” and “give” information. Think in terms of what information you need to “give” and what do you need to “get.”

Aget-well card is an example of giving a message in an informal way. In the card you could include a $20 gift card for pizza. Such a gesture communicates to your injured worker your awareness that the whole family is suffering with the mom/dad out of work, and getting a pizza is a nice thing to do for the whole family. It sends a clear message that the employer cares about the family.

 

Author Rebecca Shafer, J.D., President, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact:  RShafer@ReduceYourWorkersComp.com  or 860-553-6604.

FREE WC IQ Test: http://www.workerscompkit.com/intro/
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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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com

 

How A Safe Workplace Benefits Employers and Employees

Maintaining your company’s profit margin can oftentimes be complicated. However, removing obstacles to employee productivity helps lower workers' comp costs, increases productivity, and profits, thus making your work place a safe and efficient environment.
 
Spending money to make your workflow more efficient and safe for your employees pays the company back in dividends, saves money on injury claims and workers’ compensation costs in general, and raises productivity. The main goal in any business is to maximize profits while lowering operating costs. Therefore, when your workforce experiences high injury rates, or reduced productivity, it is wise to thoroughly examine your company's workflow, and eliminate issues causing both injury and limiting productivity.
 
Identifying and correcting areas within your business with productivity and safety concerns helps make your employees’ jobs easier and safer. Companies engaged in high volume production make the workflow as ergonomic as possible by restructuring workflow or assembly lines, upgrading equipment, and reducing steps in product handling and transition. This not only benefit company production schedules and quotas, but also employees are naturally encouraged with the new ease of operation and become more efficient at doing their specific jobs.
 
Part of correcting productivity and safety issues includes employee safety and specific job task guidelines and training. Highly visible warning and safety signs must be posted in all parts of the workplace to help reinforce best practices and requirements. The employee break or lunch room and by the time clock are great places to post safety information. Also, post reminders to always wear and use all required company safety equipment, such as eye and ear protection.
 
OSHA and State regulations require the posting of workers' comp information for reporting accidents and making claims in common areas where this information can be accessed and read, and it is a good idea to place company safety rules, guidelines, and procedures next to them. Not only do employers satisfy state and federal regulations but it helps reinforce the company position on workforce safety requirements.
 
Implement monthly training and safety meetings to help reinforce these safety standards, to review safety and accident event procedures, and current employee issues. On-going training helps new employees remember company safety requirements, as well as helping existing employees become more safety conscience while making safety meetings accessible to employee concerns. (workersxzcompxzkit)
 
Accountability is also important in both safety awareness and productivity. Company administration should be firm on safety procedure violations and how disciplinary actions apply to employees. Employees with  prior histories of injury, or who may disregard safety guidelines and procedures are potential threats to company safety and productivity, and as distasteful as it may be, failure to impose disciplinary sanctions on willful or constant misconduct places other employees, and the company in danger.
 
These seemingly simple steps have proven, over time, to reduce the cost of workers’ compensation (20% to 50%), increase profits, and keep employees happy and productive workers.

Author Rebecca Shafer, J.D. risk managment consultant, has worked successfully for 20 years with many industries to reduce Workers' Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.


Podcast/Webcast: Claim Handling Strategies
Click Here:

http://www.workerscompkit.com/gallagher/podcast/  Claim_Handling_Strategies/index.php 
 


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.
 
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ ReduceYourWorkersComp.com.

California Employers Required to Post 2009 Workplace Injuries

All California employers were recently reminded by Cal/OSH of the requirement to post a list of job-related injuries and illnesses occurring at their workplaces during 2009. The notification must be posted at the employers’  places of business  from February 1 through April 30, 2010 for employee review. 

Employers are required to use form 300A (www.dir.ca.gov/dosh/dosh_publications/oshalog300.pdf
) to report the number of injuries each year, even if no work-related injuries occurred.  The information must include the nature of the injury or illness, the severity of the work-related incidents and the number of days the affected employees missed work. 
 
Employers with 11 or more employees, except those covered in the California low-hazard establishments in retail, services, finance and real estate sectors, must display form 300A wherever employee notices are usually posted. 
 
“The mandatory Cal/OSHA log helps employers identify recurring problems and eliminate them,” said John Duncan, director of the Department of Industrial Relations (DIR).  “Employers needing additional assistance in improving their safety programs can contact our Cal/OSHA Consultation unit for a free assessment.” (workersxzcompxzkit)
Employers who want to learn more about posting requirements and how to reduce workplace injuries can get information at www.dir.ca.gov/dosh/dosh1.html

 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, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.


Podcast/Webcast: Claim Handling Strategies
Click Here:

http://www.workerscompkit.com/gallagher/podcast/  Claim_Handling_Strategies/index.php 
 

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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.
 
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ ReduceYourWorkersComp.com.

Four Great Ways of Communicating Safety in the Workplace

1. Safety Equipment & Required Signs The safety coordinator  should determine what safety equipment is required in each area. They should then determine the location of the signs required for each area such as in the main workplace, offices, computer rooms, stairwells and parking logs. Signage should be ordered and installed promptly. Periodic reviews should be made to insure that the signs are still adequate. 2. Safety Awareness Posters An integral part  of a safety program is communication to inform workers and others entering the area about safety concerns. These should be thought provoking or humorous signs to highlight safety issues. They should be placed in high traffic areas and be rotated weekly or bi-weekly so they do not become common-place. These signs should be in all languages that are used in the workplace. Posters can be ordered from a number of vendors. 3. Safe Days Posters Communicate to  the entire workforce how well (or poorly) the safety program is working by recognizing and rewarding the efforts of employees who work safely. At the entrance of the facility, post the number of consecutive workdays without an injury for the facility and also by department. This rewards the departments that are doing well and creates competition between departments. (workersxzcompxzkit) 4. Safety Recognition & Incentive Programs A Safety Recognition  Program may be considered after the rest of the safety program is implemented, is meeting its stated objectives and goals, and is being maintained. It is a small part of an effective safety program. Safety bingo is a popular program.

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, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.

"FRAUD PREVENTION" PODCAST click here: http://www.workerscompkit.com/gallagher/mp3 By: Private investigator with 25 years experience.

We accept articles about WC cost containment. Contact us at: Info@ReduceYourWorkersComp.com.
 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers' comp issues. ©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com

Communication with Worker and Family About Return to Work Options

Limiting Employee Lost Time in Workers' Compensation by Communicating the Proper Message to Employees and their families. In workers' compensation, lost time is a multiple of what it is for a similar injury covered by a disability plan. This means that large gains from an optimistic return-to-work effort are a realistic goal in work comp claims. However, the most effective efforts begin on the day of the injury and the day following. To the family of a worker even seemingly minor injuries throw the family finances into turmoil. Therefore, the employer should be aware that the worker's own family is the employer's strongest ally for return-to-work efforts. Yet this alliance will not take place unless the employer communicates the proper message. 1- On the day of the injury, the employer must send the highest ranking executive available directly to the accident site. If more than on-site first aid is required, the same executive should accompany the worker to a medical facility and assure the worker, in the presence of the admitting desk, that medical bills will be paid. NEVER leave an employee wondering if a bill will be paid. This is the single greatest cause of litigation and extended absence. 2- Next, the employer must ensure that the employee contacts a family member and communicates that the situation is under control. Wherever possible, the employee should make the first call but the employer should be available to reassure the family that assistance is underway. 3- Following that, if the employee will not be admitted, arrangements must be made to transport the employee home, again accompanied by the executive, with a plan to secure and return the employee's car to the house. At the home, the executive must ascertain if the family will need assistance for essential errands. 4- During the initial period of lost time, phone contact should be maintained with the employee and family on a regular basis to monitor progress, provide reassurance, communicate with the workers' comp insurance carrier, and always to plan for a return to work program as soon as the treating physician agrees, even on a modified or reduced-time basis. Spouse as Ally in Return to Work Efforts. A secret, well-known to workers' compensation attorneys who represent workers, is how often a spouse will call (on a confidential basis) and plead that someone get the worker out of the house and back to gainful employment. Another fact known to workers' attorneys is how many claims are generated by the anger in a spouse who feels that the employer has abandoned the worker (and the family). This attitude will become set in stone long before a carrier can begin to manage a claim unless the employer has maintained the proper relationship. The emotions which arise in the first two days will persist throughout the claim. If they are positive the employee's family will assist in a rapid resolution of the claim. For the employer, this will translate into less lost time, lower workers' compensation costs and higher workplace morale. There will be other benefits, unseen but firmly fixed, in the gratitude of a family that is a member of your business community. Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers' compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. Try the WC Cost Calculator to show the REAL COST of work comp. Look at WC 101 for the basics about workers comp. Workers' Comp Kit® is a web-based online Assessment, Benchmarking and Cost Containment system for employers. It provides all the materials needed to reduce your costs significantly in 85% less time than if you designed a program from scratch. Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs. ©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com

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