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Leakage is defined as dollars lost through over payment of medical expenses, indemnity benefits, and claims handling cost -- all ultimately resulting in the employer paying higher workers compensation premiums. Leakage also refers to the difference between what was paid on a claim and the amount the adjuster should have spent on the claim. Leakage can be either hard or soft.
Hard leakage means there is no doubt the payment should not have been made. Examples include: no coverage, a payment is not owed, or an unquestionable overpayment. Soft leakage is more subjective and includes payment of a questionable compensability claim or a high-negotiated settlement.
Adjusters, supervisors, and claim managers are reluctant to admit they make monetary mistakes and the internal file reviews they conduct generally do not look for financial mistakes -- they check criteria and grade process, except in the best TPAs and carriers.
Leakage Audits Find 18 Types of WC Claim Leakage
Bundled Program Leakage vs. Unbundled Program Leakage
And view sample pages and learn more about the this topic in the 2012 Workers Compensation Management Program book to design a workers compensation management program.
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What is therapy management, and why do therapy services need to be managed? Physical and occupational therapy is no different than other medical costs that have skyrocketed over recent years. Is this a new concept, and who should use it? Will it help lower WC cost? Greg D'Ambrosio, vice president of client services for the Network Synergy Group, provides insight to the world of therapy management.
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The first week following an accident is a one-time period for opportunity. A diligent employer can, in those first seven days, shape the outcome of a claim. Once the first week passes without action it can never be regained. And the first week is exclusively the employer's. Read more.
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Faster Growth in CA WC Indemnity Costs-Per-Claim, Broad Metrics Show VA to be a Lower Cost State, but Medical Costs per Claim Higher than Most, Broadspire Offers News and Ideas You Can Use, WCRI Study Provides Baseline to Measure Impact of 2011 Reforms on NC WC, and more.
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This desk reference includes information about setting up medical networks and settling claims in California. Avoid common program pitfalls with this lesson plan to cost containment which is the difference between success and failure. New material in 11 chapters! This 183-page step-by-step manual is available with your company logo. |
Last week, a decision in the New York Court of Appeals sent a chilling message to employers and carriers. Soon, in the future, it might be sending the same message to workers and the comp lawyers. What is it?
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This has to sting! A Yolo County, California jury has convicted a West Sacramento resident and 25-year employee of The Sacramento Bee's finance department of workers compensation insurance fraud. Read all about it.
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An assessment of the facility by Saskatoon's VFA Inc identified a number of infrastructure deficiencies, including those related to fire protection, accessibility, asbestos abatement, and ergonomics of the equipment, ventilation, the electrical system and age of the equipment.
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Starting in 2012, all eligible employers will be able to spread equal payments more conveniently over the calendar year. The period from January to March is payment free for new assessment bills, According to a report from WHSCC. Learn more about this option.
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A Pembroke Dock, Wales construction company and its director have been prosecuted after a laborer suffered serious injuries on a construction site, according to the Health and Safety Executive.
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New summaries for "drug testing and workers compensation state laws" for every jurisdiction are NOW posted on our website. Click on the link above to check it out. |
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RIMS Conference and Exhibition is the largest industry conference. Whether you are new to workers compensation or have years of experience, there are seminars to teach cost containment techniques at your level. |
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Our premium book includes gaining commitment, employee communications, integrating with your TPA, return to work, medical cost containment, settlements, safety, and much, much more . . . |
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REDUCE WC COST 20% to 50% |
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Workers Compensation Management Program |
Learn more about our book on
COST SAVINGS
for employers. |
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