A common fact often forgotten is workers’ compensation claims are medical injuries and medical expertise is needed to get the best claim results. The workload of the everyday adjuster is unrealistic to expect accurate and appropriate medical determinations. This session will go in-depth on how to leverage evidenced-based medicine guidelines to empower claims handlers and drive positive claim outcomes.
This session will cover:
– Integrating evidence-based medicine tools into your claims process
– Avoiding excessive medical treatment and unregulated compound prescriptions
– Getting appropriate treatment approved
– Proper utilization of doctor questions to push for needed interventions
– Proper utilization of IME questions to move the claim toward resolution
– Inappropriate use of Utilization Review