Differences in Medical Care and Workers Compensation Bill Review

The goal of any medical service review process is to ensure that everyone is satisfied. Bill review is a service provided by a third party that acts as an intermediary between the worker, the employer, and the insurance company to ensure that the needs of all of those involved are being met. These types of services can be used for anything medically related to ensure accuracy of charges. The key is that the information provided by the review provider is personalized to meet your specific needs.

Workers compensation insurance is a benefit provided to an employee who is hurt on the job. With workers comp, the employee will receive the care they need to recover from an injury or work-related illness. It is not designed as total wage replacement and eventually the employee is expected to return to work. Between the employee, employer and insurance company, keeping everyone satisfied is difficult. The care provided has to at least be adequate but not excessive so bill review is a great tool that can be utilized to ensure that everyone is satisfied.

Medical procedures and follow-ups with a medical provider can add up quickly and it's easy to get carried away. Medical bill review is used as a tool that indicates the approximate return to work date for the employee as well as highlights anything that the insurer or business may deem unnecessary for recovery. In terms of cost containment and accurate medical care, these types of analysis are extremely useful for workers compensation.

Medical service bill review in general differs from worker's compensation because it encompasses all medical bills, not just those incurred in relation to an on-the-job injury. For instance, if an employee goes to an out-of-network physician because they got hurt on vacation, the reviewer will catch the discrepancy and notify the concerned parties that this medical visit will be more expensive. It has nothing to do with being hurt on the job but since medical insurance is carried through an employer, management software or a review company is still utilized.

All of the aspects of medical bill reviews can be used generally for medical care or for workers compensation more specifically. The benefit of personalized review through a specialized provider is the customization of the information. Workers compensation requires return to work estimates whereas general medical reviews are utilized to highlight medical care discrepancies like using an out-of-network physician. No matter what the system is used for, it's a great way to ensure personal service and rigorous cost containment.

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9 Tips for Reducing Workplace Stress and Lowering Workers Comp Claims

Annual work-related stress claims cost U.S. companies $200 billion to $300 billion a year, according to the American Institute of Stress.

Stress can result in a number of secondary mental and physical illnesses and direct physical injuries, which directly affect health care costs, worker productivity and can even result in workers' comp claims.

In fact, workers' comp claims resulting from job-related stress last about four times longer, at an average of 23 days, than the average days lost from all nonfatal occupational illnesses and injuries combined, ac- cording to the U.S. Bureau of Labor Statistics.

And a study published by The Journal of Occupational and Environ- mental Medicine suggested health care administering costs were twice as high for workers claiming job-related stress.

The National Institute for Occupational Health and Safety defines work-related stress as emotional and harmful responses occurring when job requirements don't match a worker's resources, needs or capabilities.

Some employers still don't take work-related stress very seriously, but based on the numbers, the consequences and the costs for ignoring the issue, you would be wise to do so.

To combat the effects of work-related stress, you need to know what causes it in the first place.

There are a number of factors that cause stress in the workplace, but the most common, according to the National Institute for Occupational Health and Safety, are:

Poorly designed jobs and tasks from heavy workloads; shift work; long working hours; too few or too short rest and meal breaks; and tasks that don't have inherent meaning, that don't utilize the worker's skills or that don't give the employee a sense of control.

Job roles, expectations and responsibilities that are too broadly defined, vague, conflicting or unclear. Poor management skills, including inadequate communications skills, lack of encouragement or incentives to participate in decision making.

Career concerns, including few opportunities for advancement or a lack of job security. Poor workplace conditions, including inadequate ergonomics, air pollution, noise or even dangerous or unpleasant working environments.

If you are able to pinpoint the causes of stress in the workplace you can take steps to reduce those factors. Here are nine ways you can reduce stress among your staff:

Improve communications. Try to get your employees involved and let them know they are valued. Ask them for feedback and input on company plans, processes and management decisions.

Give staff more sense of control. Within responsible and reasonable limits, you should give employees independence in the day-to-day operations of their job. Let them think outside of the box and they may innovate and find a way to do their jobs better and more efficiently.

Create an open forum. Employees should be free to express their frustrations, concerns, and complaints without fear of retaliation from management or supervisory staff.

Keep employees in the know. Uncertainty can be eliminated by simply apprising employees about upcoming changes and what these changes will mean for them.

Reduce any excessive workloads. Don't overload your employees beyond their abilities. Try to spread out workloads and don't pile on too many projects at a time on one person..

Clearly define job descriptions. You should make sure that all employees have a thorough understanding of their roles in the company and the responsibilities of their position.

Create realistic schedules. Be as flexible and approachable as possible if a staff member needs to take time for a doctor's appointment or has a sick child. Remember that all of your employees have a life and demands outside of work.

Play to your employees' skills. A job should stimulate employees, challenge them and require as many of their skills as possible. Give your staff opportunities like advancement and cross-training if they show the desire to bring more value to their jobs and your organization.

All work and no play... Make sure you allow staff to let loose once in a while by organizing company picnics, parties or team sports like a softball league.

Above all else, in order to keep your workers compensation claims low, practice these tips for happier, more productive employees!

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Workers Compensation Insurance: How Safe Is Your Workplace?

A safe workplace is obviously essential for your employees' health and well-being, but it is also important when you consider the insurance costs for workers compensation insurance. Making sure your workplace is as safe as possible is typically inexpensive and takes very little time regardless of your business. Every penny and minute spent on identifying and preventing hazards can be worth thousands of dollars if there is an accident on your business premises for which you are found to be negligent. Depending on your type of business, remember that this applies for employees and customers alike.

The first step is identifying the hazards in your workplace. Knowing what potential hazards you, your employees, and the public may encounter is critical to implementing effective preventative measures and reducing workers compensation insurance costs. Here are a few of the ways you can identify hazards in your workplace:

--Ask employees: Depending on the nature of your business, employees may be your best source of information since they're responsible for carrying out the tasks your business needs to function. They are probably well aware of any risks and hazards in their daily duties, so they're your first line of defense.

--Perform safety checks: Assess the daily tasks that could cause harm and communicate these risks to staff that may not know the potential hazards.

--Review past on-the-job injuries: Examine any illnesses or injuries that you've already experienced, including their frequency and severity, so you know the best way to use your resources.

While all businesses have safety issues specific to their industry, there are many common hazards that can affect any company. Most studies place trips, slips, and falls as one-third of all major workplace injuries, the most common cause of injuries at work. Legal actions for failing to have insurance to cover workers compensation as a result of these types of injuries can be devastating to your business.

Whether you run a mechanic's shop or an office, pay close attention to these common workplace hazards that, if ignored, can result in a workers compensation insurance claim:

--Look for slip and trip hazards, such as uneven floors, trailing cables, and floors that are often wet. Make sure the workplace is cleaned regularly and that spills are cleaned-up immediately. Even if your business seems impervious to these risks, think about the worst thing that could happen to your business and how much you may have to pay in the event of an injury.

--Be aware of electrical hazards: If any employees interact with electrical machinery, you obviously need to ensure that regular maintenance is performed on all electrical areas of your business that may come into contact with your employees and customers.

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Long Term Workers Compensation

Workers compensation is something most people in a typical job won't have to think about. Usually, unless you work in a particularly dangerous work environment, you most likely don't even know the kind of coverage you have. However, if something happens then you'll be glad you are covered and have it. This form of insurance covers medical bills, provides financial aid and covers the period during which you are out, not working. So what happens if you are out of work for a long time, maybe forever? Long term workers' compensation can cover you as well.

First let's be clear on what exactly most workers compensation policies cover. The point of the policy is to provide help should something happen in direct relation to your work. That means when you're at your job site, whether it's a business office or a project ground of some type, and you're doing your assigned duty, then if an accident occurs, you'll be covered. It's important to note that in most situations, this is only the case if your injury came from your assigned duty. That means something in your job description. For example, if you were helping out someone else to create a make shift elevator on a construction site, when you were supposed to be painting walls, that probably isn't a very good idea. You could well find yourself on your own.

Once you know you're covered, what kind of injuries can lead to permanent disability benefits? Someone on a construction site could fall down and break his spine, for example, making him unable to walk anymore. This would prevent him from doing his job, and then he would be covered by the workers compensation. Someone in an office could be working on a computer, and a lamp falls on top of him, blinding him for life. This would also be covered. There are many more examples, but just think of something that would completely prevent you from doing your job, in which case workers compensation would be there to help. It's generally not a pretty picture when this happens, and it's not something anyone would want, but like any insurance, at least the coverage exists if you need it.

In actual real life situations, coverage does change from one place to the next, so if you're working in a dangerous environment, it's important for you to know what you're covered for, and what will actually be paid should something happen to you. It's always better to be prepared, than find out when it's too late that you would have been better off doing another job. Long term and permanent workers compensation is something that is much scrutinized, because it costs a lot to the employer, and only these extreme cases are considered.

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The First Rules In Workman's Comp

Lots of people everyday work at jobs which involve situations in which they could become injured. This is why employers are required to purchase workers compensation insurance. Workman's comp exists in every state within the United States. In most cases the system should involve a worker who is injured or has become ill due to the work environment. Instead of suing the employer they file a claim against their employers workers comp insurance.

Workman's comp is designed to help the worker. It is to help financially fund a worker who has been experienced some time of illness due to the work place. However, it does sometimes produce outcomes that are less than desired by the party injured or ill due to an employer's negligence. The system is complex. It is not an easy or fast process. Many people who file workers compensation claims find it in their bets interest to work with a lawyer that specializes in these issues for help on the claim. Some unions also offer legal support to victims.

There are requirements that must be met by the employee to even be considered able to file a workman's comp claim. The two basic necessities are as follows; the employee must have worked for a company that carried workers compensation insurance. All companies are supposed to have this insurance coverage but not all companies abided by the laws governing society. Also they must have been injured during work or have an injury specific to the job duty.

The most important step the employee can make in the claim against an employer for workman's comp benefits is notifying them immediately that a work place injury has happened. Many workers are afraid to do this obvious step in the process because of bonuses and incentives companies often put on the number of days that a work place has been injury free. However, this is absolutely no reason to let an injury go without being reported on.

Even if an injury is extensive, if an employee fails to report it right away that gives the carrier reason to deny the legitimacy of the claim therefore denying benefits to a deserving employee. It is without a doubt the very first key element in a long and lengthy battle to gain compensation under the laws surrounding workman's comp. It is also important to realize the longer it takes the more flags that will be raised and the carrier will look more thoroughly into the claim thinking it is perhaps fraudulent and without just cause.

Even after a worker has filed a claim with their employer there is still more work to be done to prevent any case they might have against the claim. The next step is to report the accident to the state workers compensation board in which the worker works and lives. This will make sure that all the necessary paperwork has been filled out and obtained to proceed with the claim.

It is important that an employee document the accident for their records also. Keep copies and records of all communication regarding the accident. Employers should also obtain information from the employee. It is important to describe the specific accident, the names of the people that saw it happen; when the accident occurred, under what conditions and where exactly did it occur.

This is just the beginning of a journey involving lots of documentation and paperwork. Most employers don't ever want to get involved in such situations because they are time consuming and expensive. However, even with the best employers who offer work places that are desired it is possible that an injury occur. This is why it is important even for small companies to carry workman's comp insurance.

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What If My Employer Doesn't Have Workers Compensation?

Today, there are a lot of employers that don't have workers compensation plans for their employers. It is extremely important to know what your employer is offering and, if you know that they don't have A compensation plan, you need to make sure that you are planning. Workplace accidents and injuries happen on a daily basis throughout the country. Make sure that you have a plan for what to do if you have to work without this type of coverage.

Ask Them to Get Coverage

Depending on who you work for, you may have union rights, if you do, use the bargaining options that they have to ask for compensation benefits. You want to make sure that you are taking a look at the bargaining rights that the union offers and use that to help you. Otherwise, you also want to make sure that you are working with your employer and the other employees to make sure that you are getting what you need for coverage.

Find Short Term Disability Plans Individually

If you are looking for an option that will replace workers compensation, you want to take a look at short-term disability plans. These are plans that will cover you for a set period of time if you are injured and will help you pay for bills. This is not a long-term solution, nor is it a workers compensation plan, but it is enough to help you get what you need.

Find a Group Sponsored Individually Paid for Coverage

When you know that your employer is not going to offer workers compensation, get together a group and make sure that you find what is out there. You will find that you can actually get some great group rates on individual coverage like disability or AFLAC (American Family Life Assurance Company) without actually having to have a workers compensation plan through work. It is a great idea to get coverage this way.

Get a New Job

Honestly, if your company doesn't offer compensation coverage, you may want to determine if you want to work there. Workers compensation is an extremely basic insurance coverage and not offering this is a sign that your employer may not be working in your best interest. If they are not offering insurance coverage in general, you want to make sure that you are deciding if you have an employer that is going to support you.

Getting the coverage that you need for your company is really important. Workers compensation is a basic coverage level; however, you may find that there are a lot of employers that don't offer it. If your company doesn't offer workers compensation, you want to make sure that you are finding a way to get what is going to work the best for you. You need to make sure that you have some sort of coverage in place that is going to take care of you in the event that you are hurt on the job and need coverage.

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