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WORKERS’ COMP CLAIMS REVIEW CHECKLIST: 9 MUST-HAVE, SERIOUS-IMPACT ELEMENTS
A claims review is often the only time a structured, planned communication occurs among all stakeholders involved in a claim. This meeting is an ideal opportunity to come together as a team and work to close claims sooner and more effectively. Setting expectations early in the claims audit/review process is essential, and the importance of communication cannot be stressed enough.
Learn 9 serious-impact elements of a Workers’ Comp claims review including:
Selection of Claims to Audit -The choice of which claims to include is critically important when preparing for an audit. A company with a small number of claims can include every file in the review, but those with several hundred or greater must have a system to select which claims to analyze.
Claims Indicative of Potential Problems - Selecting which claims to include in a review is both art and science. Do not include the names or other personal information about the injured workers during selection to avoid any emotional attachment or influence.
Medical Doctor’s Crucial Role - The single party most often missing in a claim review is the MD. They are the best person to address the validity of the injury, length of time the employee must take off from work, and an approved form of therapy.
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