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

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.

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.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2023. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.