502.495.5040

Breaking Bad Comp Style

Sep
19

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Some say, in real estate, it’s… Location, Location, Location! In workers’ comp, we say it’s…

Early Intervention, Early Intervention, Early Intervention!

Writing in Claims Journal, Robert T. Lewis highlights a published graph from NCCI that summarizes the staggering increase in average medical costs for lost time claims.

Twenty years ago, the average medical cost was only $8,000. Bad enough, but in 2012, the average medical cost had skyrocketed to over $28,000.

 

Lewis explains how the job of a workers’ comp adjuster has become extremely difficult due to the complexity of medical issues. These include:

 

  • Addictions;

  • PolyPharmacy;

  • RSD/CRPS;

  • Pain Management;

  • Psychological Issues.

 

Toss in fraud, bad economy, entitlement mentality, and a few rogue providers, and you have a recipe for costly and never-ending claims. Even the most seasoned adjuster needs help managing the simple claim that will eventually break bad.

 

At OMCA, we work with our clients to establish early intervention triggers that help our aggressive medical case management improve outcomes. These guidelines are tailored to exposures, demographics and industry trends including:

 

  • Narcotic duration;

  • Excessive diagnostic/surgery requests;

  • Symptom subjectivity/relatedness;

  • Overall dollar outlay;

 

If your medical management vendor is just paying lip service to early intervention, early intervention, early intervention, your claim may end up in the wrong location, location, location.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Posted in OMCA