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Your Ultimate Guide to Mastering Workers' Comp Costs : Reduce Costs 20% to 50%.

One book that covers how to assess your workers' compensation program, design the most cost-impacting strategy, roll out comprehensive changes to your organization, and monitor and manage the program going forward.

Bibliographic Details
Main Author: Shafer, Rebecca.
Format: eBook
Language:English
Published: Minneapolis : Advisen Ltd, 2014.
Edition:1st ed.
Subjects:
Needs assessment.
Personnel management.
Social case work.
Electronic books.
Online Access:Click to View
Table of Contents:
  • Intro
  • Cover
  • Copyright
  • About This Book
  • Order Form
  • Table of Contents
  • Author's Note
  • Chapter 1: Workers' Compensation Insurance Basics
  • Purpose of Workers' Compensation
  • Who Pays for Workers' Compensation
  • Parties Involved in Workers' Compensation
  • Benefits for the Employer
  • Independent Contractors
  • Benefits for the Employee
  • Injuries Covered
  • Determining Compensability
  • Aggravation vs Exacerbation
  • Standard Defenses
  • Types of Workers' Compensation Insurance
  • How Losses Are Categorized
  • How Losses Are Reported
  • Reducing Your Premium
  • Calculating Your Premium
  • How Mod Affects Your Premium
  • Good/Bad Mod Examples
  • Ways to Reduce Your Mod
  • Unit Statistical Date
  • Types of Insurance Structures
  • Voluntary Markets
  • Alternatives to Voluntary Markets
  • Collateral Requirements
  • Chapter 2: Fundamentals of Cost Containment
  • Reasons Workers' Compensation Costs Are High
  • Who Is in Charge
  • Work Ability Form Properties
  • Who Is Responsible for Managing Workers' Compensation Claims
  • Who Is Responsible for Managing Workers' Compensation Process
  • Hidden (Indirect) Costs of Workers' Compensation
  • Additional Costs
  • Calculating Workers' Compensation Costs
  • External Obstacles to Cost Control
  • Internal Obstacles to Cost Control
  • Chapter 3: Training and Building Commitment
  • Implementing a Workers' Compensation Program
  • Key Training Responsibilities
  • Management Awareness
  • Presenting to Supervisors
  • Conflicting Roles of Supervisors
  • Supervisors Must Be Involved
  • Develop Supervisor Guide
  • Building on Success
  • Consider Use of Tools
  • Bringing Employees on Board
  • Your Company Message
  • Workers' Compensation Implementation Timetable
  • Chapter 4: Injury Management Best Practices Roles and Responsibilities
  • Injury Coordinator Best Practices
  • Supervisor Best Practices.
  • Employee Best Practices
  • Middle Manager Best Practices
  • Risk Manager Best Practices
  • Medical Department and Medical Director Best Practices
  • Senior Management Best Practices
  • Special Investigation Unit Director Best Practices
  • Legal Department Best Practices
  • Chapter 5: Reporting the Claim
  • Immediately Report All Losses
  • Critical Issues
  • Reporting Procedure
  • Intake Procedures
  • Essential Intake Considerations
  • Injury Triage
  • Employer's First Report of Injury
  • What Is Included on the FROI
  • Completing the FROI
  • Penalties
  • Chapter 6: Post-Injury Response Procedure
  • Post-Injury Response Procedure Guidelines
  • Benefits of a Consistent Post-Injury Response
  • Post-Injury Response Worksheet
  • Implementing Post-Injury Response on the Road
  • Sample Post-Injury Response Procedure
  • Summary Steps and Format
  • Chapter 7: Communication with Employees
  • Proactive Communication
  • Reactive Communication
  • Keep Complete Record
  • Two Types of Communication
  • Employee Brochure
  • Meeting with Your Employee
  • First Day Phone Call
  • Weekly Contact
  • Weekly Meeting Guidelines
  • Scheduling Weekly Meetings
  • Reducing Attorney Involvement
  • Chapter 8: Working with Your Insurance Adjusters or TPA
  • Claims Adjusters
  • What Is a TPA
  • Adjuster File Assignments
  • Dedicated vs Designated Claims Units
  • Bundled and Unbundled Services
  • Deductible vs Control
  • How to Select a TPA
  • Learning About Your Claim Partners
  • Preparing for the TPA Visit
  • Meeting with Your Claims Handler
  • Chairside Visits
  • Doing a National Rollout
  • Vendor Day
  • Account Handling Instructions
  • Reviewing Open Claims with the TPA
  • Reserving Practices
  • Information Needed to Establish Reserves
  • Reserve Calculation Worksheets
  • Reasons Reserves Are Higher Than Expected
  • Verifying Reserves Accuracy
  • Plan of Action (POA).
  • How to Evaluate a TPA
  • Medical Management Quality Review
  • Quality Control File Audit
  • File Reviews and File Audits
  • Audit Timing
  • File Review Procedures
  • File Audit Procedures
  • File Audit Participants
  • MD Participation
  • How to Control Leakage
  • What Is Leakage
  • Types of Leakage
  • Causes of Leakage
  • Leakage Claim Audits
  • Leakage Identification Checklist
  • Chapter 9: Safety and Loss Control
  • How to Develop an Effective Safety Program
  • Initial Assessment
  • Assignment of Roles and Responsibilities
  • Record Keeping
  • What OSHA Requires
  • Select Safety Committee, Chairman, and Recording Secretary
  • Safety Committee Responsibilities
  • Safety Committee Meetings
  • Communication Methods
  • Conduct a Thorough Workplace Assessment
  • Hazard Correction/Safety Work Order Tracking System
  • Develop Written Policies, Procedures, and Programs
  • Accident Investigation Program
  • Education and Training: Employees, Supervisors, and Managers
  • Who Receives Training
  • Safety Equipment Required Signs
  • Communicate Safety Often
  • Safety Awareness Posters
  • Safe Days Posters
  • Safety Recognition and Incentive Programs
  • Employee Screening
  • Hiring Safe Employees
  • Job Analysis
  • Screening Tools
  • Chapter 10: Wellness Programs
  • Wellness in the Workplace
  • Benefits of Wellness Programs
  • Incentives for Wellness
  • Negative Effects of NOT Having a Wellness Program
  • Types of Wellness Programs
  • Weight Control
  • Smoking Cessation Programs
  • Depression/Anxiety Awareness Treatment
  • Migraine Headache Management
  • Substance Abuse Treatment
  • Drug, Alcohol, and Substance Abuse Policy
  • Drug, Alcohol, and Substance Abuse Testing
  • Putting Wellness Programs into Practice
  • Chapter 11: Return to Work and Transitional Duty
  • Cost Savings
  • Measuring Effective of Return-to-Work Programs
  • Transitional Duty Policy Overview.
  • Benefits
  • Program Goals
  • Drafting a Transitional Duty Policy
  • What to Include in a Transitional Duty Policy
  • Characteristics of Transitional Duty Assignments
  • Transitional Duty Program Pay Rate
  • Estimating the Duration of an Injury
  • Medical Treatment Guidelines
  • Medical Treatment and Comorbid Conditions
  • Using Medical Treatment Guidelines
  • Using Injury Treatment Guidelines to Estimate Cost Savings
  • Types of Transitional Duty
  • Modified Duty
  • Alternate Work
  • Alternative Off-Site Jobs
  • Non-Profit, Volunteer, or Charitable Positions
  • Transitional Duty Tips
  • Putting Return-to-Work into Action
  • How to Identify Transitional Duty Jobs
  • Employees Who Never Return to Work
  • Overlapping Benefits
  • Americans with Disabilities Act (ADA) Key Points
  • Coordinating Workers' Compensation with Federal and State Leave Statutes
  • Workers' Compensation, ADA, and FMLA Interactions
  • Case Study
  • Working with Unions
  • Chapter 12: Other Indemnity Cost Containment Methods
  • Work Hardening
  • Independent Medical Evaluations (IME)
  • Before the IME
  • Customize Medical Inquiries
  • Timeframes for Scheduling and Obtaining IME
  • Functional Capacity Evaluations (FCE)
  • Retraining Programs
  • Telephonic Disability Intervention
  • Translation Services
  • Transportation Services
  • Layoff Planning
  • Chapter 13: Directing Medical Care
  • Gain Cooperation from Medical Providers
  • Types of Doctors
  • Remote Health Services
  • Methods of Doctor Selection
  • If the Employer Can Direct Care
  • If the Employer Cannot Direct Care
  • Ten Considerations for Your Company Doctor
  • Eleven Reasons NOT to Select a Doctor
  • The PRIMARY Treating Physician (PTP)
  • Understand the PTP's Perspective
  • Information You Need from the Doctor
  • Understanding KEY Medical Injury Terms
  • California Medical Provider Network (MPN).
  • Chapter 14: Medical Cost Containment
  • Medical Cost Containment Services
  • Utilization Review Accreditation Commission Certification
  • Preferred Provider Organizations
  • Injury Triage
  • Telephonic Nurse Case Management (NCM)
  • Field Case Management (FCM)
  • Mental Health Registered Nurses
  • Chronic Pain Programs
  • An Aging Workforce
  • Medical Review
  • Medical Advisors and Medical Directors
  • Independent Medical Evaluation (IME)
  • Durable Medical Equipment (DME)
  • At-Home Recovery Services
  • Medical Bill Review
  • Medical Fee Schedules
  • Usual and Customary
  • Hospital Bill Reviews
  • Using a Diagnosis Related Groups (DRG) Review Company
  • Cost Savings Using DRG
  • Medical and Hospital Bill Review Considerations
  • Chiropractic Care
  • Chapter 15: Fighting Fraud and Abuse
  • When to Investigate a Claim
  • Types of Investigation
  • Red Flags of Fraud
  • Medical Terminology Used to Identify Malingering
  • Important Times to Use Surveillance
  • How to Use the Results
  • When Not to Use Investigation
  • Reviewing Investigation Reports and Videos
  • Avoid "Good Day/Bad Day" Syndrome
  • Additional Fraud Controls
  • Chapter 16: Rehabilitating the Injured Employee
  • What Is Physical Therapy
  • What Is Physical Rehabilitation
  • What is Occupational Therapy
  • What is Vocational Rehabilitation
  • Provider Differences
  • Physical Therapy
  • Physical Therapy Management
  • Determining Rehabilitation Needs
  • Reasons for Physical Therapy
  • Measuring Outcomes
  • Doctor's Reevaluation
  • Determining Therapy Outcomes
  • Physical Therapy Settings
  • Physical Therapy Office Characteristics
  • Physical Therapy Cost
  • Physical Rehabilitation
  • Physical Rehabilitation Networks and Specialties
  • Medical Assessments
  • Cost of Physical Rehabilitation
  • Physical Rehabilitation Facilities
  • Measuring Physical Rehabilitation Outcomes.
  • Occupational Therapy.

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