ESM saved a SIG’s members $21,000 by asking a simple question of the Office of Self Insured Plan’s (OSIP) chief. “WHY?” Click to read more...
Read More
We have seen UR fees run anywhere from $98 to upwards of $9,500 per treatment.
- Routine treatment such as PT, diagnostics and consults are usually approved with an average UR fee up to $500 per review.
- The UR cost drivers are surgeries and opioids/narcotics - whether approved, modified or denied.
- We recently saw a TPA charge $9,500 in UR fees for a request for spine surgery because of the unbundling of the Utilization Review and fees.
While safety is top of mind for most employers, it typically takes a backseat to production and sales. Completely understandable because without products and sales the business and its benefits simply cease to exist. However, what should be considered in your strategic planning is the cost of risk.
Read More
ESM achieves a 39 point X-Mod reduction for an employer by identifying a carrier error in the claim classification reported to the Workers’ Compensation Insurance Rating Bureau (WCIRB).
Read More
Effective Jan. 1, 2017, all insured employers within the state of California must report all claims to their carrier or Third Party Administrator for which medical treatment costs are incurred. This includes reporting of first aid claims. If you have previously paid your “first aid” claims directly to the medical clinic, these costs must now be reported to the carrier and will impact your future Experience Modifier.
Read More
An active and effective safety committee whose membership and functions are reflective of the company’s size, complexity, and operating exposures will play a key role in the overall performance of that company. The Safety Committee is established to be of benefit first and foremost to the employees it represents, but it is also established as a safeguard and protector of the Company’s assets.
Read More
In 2011, Cal-OSHA enacted Assembly Bill 2774. Part of the new legislation included expanding the definition of “Serious Physical Harm” to include a 4th element. Well, if you are still unsure, fret no longer! Here is the definition straight from the amended labor code
Read More