What's New : 31-60 Days : Claims Management


Insurance claims handling administration for property and liability claims, WC claims, auto claims, bond claims. Claims reporting procedures. Injury management and return to work programs. Claims reserving practices. Structured settlements. Claim audits. Use of PEO's and TPA's

Sub-Categories with new or updated resources include: Health Claims Code Sets, Medicare Set-Aside, Property Claims, Return to Work, WC Claims, WC Decisions, WC EDI, WC Fee Schedules, WC Forms, WC Managed Care


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Claims Management » Health Claims Code Sets
DRG, APG & ICD-9-CM and ICD-10-CM coding - Medicare payment rates


Updated Seven Tips to Improve Your ICD-9 Coding for Diagnostic Tests [16174] Seven Tips to Improve Your ICD-9 Coding for Diagnostic Tests : Resource Info
You can prevent costly claims denials by following these guidelines


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Claims Management » Medicare Set-Aside
WCMSA Workers' Compensation Medicare Set-Aside materials


Updated National Alliance of Medicare Set-Aside Professionals [33321] National Alliance of Medicare Set-Aside Professionals : Resource Info
Non-profit association exclusively addressing current issues and challenges of Medicare Set-Aside arrangements


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Claims Management » Property Claims
Property insurance claims management materials


Updated Property Valuation [34320] Property Valuation : Resource Info
A series of articles on the application of replacement cost, optional property insurance values, gaps in replacment cost


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Claims Management » Return to Work
Managing workers compensation costs by returning injured workers to work


Updated Best Practices for Early Return to Work Program [pdf] [32935] Best Practices for Early Return to Work Program : Resource Info
Guidance for developing a transitional duty program

Updated Ontario, Canada: Return to Work Guidance [18941] Ontario, Canada: Return to Work Guidance : Resource Info
Guidance on early and safe return to work programs


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Claims Management » WC Claims
Managing the costs of workers compensation claims


Updated Checklist for Handling Workers Comp Claims [11102] Checklist for Handling Workers Comp Claims : Resource Info
Employer checklist for WC claims

Updated IME: Independent Medical Examinations [16671] IME: Independent Medical Examinations : Resource Info
Legal guidance concerning IMEs for claimants

Updated Neurotrauma - Brain Injury [5313] Neurotrauma - Brain Injury : Resource Info
Understanding brain injury

Updated Third Party Claims [16670] Third Party Claims : Resource Info
Third party claims under Wisconsin law

Updated Understanding Spinal Cord Injury [5312] Understanding Spinal Cord Injury : Resource Info
Provides an overview & statistics on demographics, cost, morbidity, causes, consequences, etc.


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Claims Management » WC Decisions
State WC board decisions, court rulings, amicus curiae briefs on WC cases


NE-Nebraska WC Court Decisions [15322] NE-Nebraska WC Court Decisions : Resource Info
Archives from 1999 to the present


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Claims Management » WC EDI
State EDI requirements


Updated GA-Georgia ICMS System [32926] GA-Georgia ICMS System : Resource Info
ICMS - Integrated Claims Management System - includes EDI and web submissions

New PA-Pennsylvania EDI Requirements for WC [36290] PA-Pennsylvania EDI Requirements for WC : Resource Info
Electronic Data Interchange (EDI) involves the computer-to-computer exchange of data between companies and the State


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Claims Management » WC Fee Schedules
Workers compensation medical fee schedules


Updated GA-Georgia Workers’ Compensation Medical Fee Schedule [27191] GA-Georgia Workers’ Compensation Medical Fee Schedule : Resource Info
Ordering information only (fees) - not online

Updated PA-Pennsylvania Charge Classes by Zip Code [23215] PA-Pennsylvania Charge Classes by Zip Code : Resource Info
The major users for this list are those who reprice medical bills to the workers' compensation fee schedule

Updated PA-Pennyslvania: WC Fee Schedule [11253] PA-Pennyslvania: WC Fee Schedule : Resource Info
Workers' Compensation Fee Schedule for Part A (Tables A through H) and Part B medical providers


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Claims Management » WC Forms
Download state workers compensation forms such as first report of injury


Updated GA-Georgia - Workers Compensation Forms [6267] GA-Georgia - Workers Compensation Forms : Resource Info
Download a large number of workers compensation forms for the state of Georgia

Updated PA-Pennyslvania - Workers Compensation Forms [10984] PA-Pennyslvania - Workers Compensation Forms : Resource Info
Access WC forms for the state of Pennyslvania


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Claims Management » WC Managed Care
Guidance on managed care in workers compensation to control medical costs


Updated GA-Georgia Best Practices for Selecting Doctors for Your WC Panel [pdf] [32936] GA-Georgia Best Practices for Selecting Doctors for Your WC Panel : Resource Info
Identifies 3 panel options available under Georgia WC law

Updated GA-Georgia Workers Compensation Managed Care & Rehabilitation Division [15241] GA-Georgia Workers Compensation Managed Care & Rehabilitation Division : Resource Info
Certifies managed care organizations for Workers' Compensation in GA



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