Workers Compensation » WC Claims Management



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rmLibrary


- Claims Management / Claims Administration : Bad faith, structured settlements, large losses, etc.
Information on claims management, e.g., structured settlements, importance of prompt reporting, construction claim guidance, preservation of evidence, etc. Self-insurance & claims administrators/adjustors selection/evaluation checklist of TPAs. Variations in imaging technology and the issues confronting claims adjusters. Experts offer tips to adjusters about salvage.



- Updated Claims Management / Health Claims Code Sets : DRG, APG & ICD-9-CM and ICD-10-CM coding - Medicare payment rates
Index of diagnosis related groups. International classification of diseases ICD-9 code query system. Calculators, manuals related to DRG, APG & ICD-9-CM and ICD-10-CM coding.


- Claims Management / WC Claims : Managing the costs of workers compensation claims
Guides to work-relatedness of occupational diseases. Activities to control disability costs. IME. How WC settlements are viewed in each state and the various forms of settlements. Cost and reserving guidelines for quadriplegia, massive injury, traumatic brain injury.


- Updated Claims Management / WC Managed Care : Guidance on managed care in workers compensation to control medical costs
Challenging hospital and doctor costs. Entire text of the results of California's survey of workers compensation managed care practices.


- Ergonomics / Medicine : Clinical practice guidelines, patient handouts on low back pain, CTS, etc.
Medical diagnosis and treatment of ergonomic-related injuries. Clinical guidelines and primary care management of acute low back pain. AHCPR guidelines on acute low back problems in adults. Teaching module for physicians and health care professionals on low back pain . Carpal tunnel syndrome. Series of ergonomic medicine guides designed for patients that provide explanations & illustrations. Medical management in an ergonomics program. Painful shoulder diagnosis and treatment.


- Health / Privacy : Medical record privacy, patient confidentiality, etc.
Confidentiality of medical information and patient records. Checklist for monitoring alcohol & other drug confidentiality compliance. Guidelines for employers regarding confidentiality of health information. Principles for health information privacy.


- Health / Stress : Mental health stress including stress resulting from workplace conditions
Stress management. Occupational job strain. Workaholic quiz. Post-traumatic stress disorder. Guide to occupational stress designed for managers and supervisors. Large number of documents on managing stress at home and at work. Job burnout.


- Updated Health / Wellness Programs : Workplace health promotion and wellness programs
Information and resource kit on creating workplace wellness programs. Profiles of corporate wellness programs of various corporations in the US. Guide for companies to control the costs associated with cardiovascular disease. Activities to promote workplace wellness. Wellness websites for employees. Small business health programs.


- Human Resources / Layoffs : Industry layoff guidance, reports, laws
Weekly layoff reports by industry. Guidance on layoffs and labor laws. How to control excessive WC claims with layoffs.


- Updated Legal / Insurance Law : Case developments, articles, resources related to insurance law
Analysis of court opinions involving insurance issues. Articles on commercial insurance, self-insurance and alternative market, etc.


- Legal / Litigation : Legal case mgt, use of computer-generated evidence, attorney-client priviledge
Attorney-client priviledge. Expert witnesses. Case management. Sentencing. Work Product Doctrine. Using surveillance tapes in the courtroom. Introduction to Basic Legal Citation. Legal bulletins focused on the hospitality industry - applicable to most industries.


- Updated Managed Care / Outcomes : Quality outcome studies and measurements - utilization review
Medical outcomes assessment and research studies. Physical Medicine Utilization Review.


- Managed Care / Report Cards : USQA Quality Reports. NCQA accreditation. CVO certification and more
JCAHO performance measurement ratings for healthcare facilities. USQA Quality Reports. NCQA Accreditation. HEDIS Report Cards. CVO certification. Health plan ranking reports.


- Updated Medicine / Brain Injuries : Traumatic brain injury reference materials
Traumatic brain injury and coma articles, fact sheets, statistics, treatment guidelines, family assistance, legal issues and more.


- Medicine / Clinical Guidelines : Full text of clinical practice guidelines for numerous specialties in medicine
Large number of medical management & clinical practice guidelines from the US federal government, medical schools, medical academies & associations. Examples: Occupational medicine, acute chemical exposures, heart disease & stroke, endocrine disorders, family practice, clinical preventive services, orthopedics, etc.


- Updated Medicine / Occupational Medicine : Large number of reference materials on occupational medicine
Guidelines for OEM professionals to establish an effective employee health program. Medical management of laser injuries & radiation accidents. Index of medical illnesses, conditions & symptoms. ACOEM workplace guidelines. Indoor air pollution and radon guides. State of California medical guidelines and advisory protocols for occupational medicine. ADA enforcement guidance on pre-employment medical examinations. OSHA medical surveillance requirements.



The Safety Library


- Ergonomics / Medical Ergonomics : Clinical practice guidelines, patient handouts on low back pain, CTS, etc.
Medical diagnosis and treatment of ergonomic-related injuries. Clinical guidelines and primary care management of acute low back pain. AHCPR guidelines on acute low back problems in adults. Teaching module for physicians and health care professionals on low back pain . Carpal tunnel syndrome. Series of ergonomic medicine guides designed for patients that provide explanations & illustrations. Medical management in an ergonomics program. Painful shoulder diagnosis and treatment.


- Health Care Safety / Patient Confidentiality : Medical record privacy, patient confidentiality, etc.
Confidentiality of medical information and patient records. Checklist for monitoring alcohol & other drug confidentiality compliance. Guidelines for employers regarding confidentiality of health information. Principles for health information privacy.


- Insurance Loss Control / Claims Management : Bad faith, structured settlements, large losses, etc.
Information on claims management, e.g., structured settlements, importance of prompt reporting, construction claim guidance, preservation of evidence, etc. Self-insurance & claims administrators/adjustors selection/evaluation checklist of TPAs. Variations in imaging technology and the issues confronting claims adjusters. Experts offer tips to adjusters about salvage.



- Updated Occupational Medicine / Brain Injuries : Traumatic brain injury reference materials
Traumatic brain injury and coma articles, fact sheets, statistics, treatment guidelines, family assistance, legal issues and more.


- Occupational Medicine / Clinical Guidelines : Full text of clinical practice guidelines for numerous specialties in medicine
Large number of medical management & clinical practice guidelines from the US federal government, medical schools, medical academies & associations. Examples: Occupational medicine, acute chemical exposures, heart disease & stroke, endocrine disorders, family practice, clinical preventive services, orthopedics, etc.


- Updated Occupational Medicine / Code Sets : DRG, APG & ICD-9-CM and ICD-10-CM coding - Medicare payment rates
Index of diagnosis related groups. International classification of diseases ICD-9 code query system. Calculators, manuals related to DRG, APG & ICD-9-CM and ICD-10-CM coding.


- Updated Occupational Medicine / Occupational Health : Large number of reference materials on occupational medicine
Guidelines for OEM professionals to establish an effective employee health program. Medical management of laser injuries & radiation accidents. Index of medical illnesses, conditions & symptoms. ACOEM workplace guidelines. Indoor air pollution and radon guides. State of California medical guidelines and advisory protocols for occupational medicine. ADA enforcement guidance on pre-employment medical examinations. OSHA medical surveillance requirements.


- Updated Wellness Programs / Disease Prevention : Materials for employers to promote workplace health and wellness
Guidance for companies to control the costs associated with workplace illness by promoting disease prevention.


- Wellness Programs / Stress Management : Mental health stress including stress resulting from workplace conditions
Stress management. Occupational job strain. Workaholic quiz. Post-traumatic stress disorder. Guide to occupational stress designed for managers and supervisors. Large number of documents on managing stress at home and at work. Job burnout.


- Updated Workers Compensation / WC Managed Care : Guidance on managed care in workers compensation to control medical costs
Challenging hospital and doctor costs. Entire text of the results of California's survey of workers compensation managed care practices.



The HR Library


- Employment Law / Health Privacy : Medical record privacy, patient confidentiality, etc.
Confidentiality of medical information and patient records. Checklist for monitoring alcohol & other drug confidentiality compliance. Guidelines for employers regarding confidentiality of health information. Principles for health information privacy.


- Employment Law / Litigation Management : Legal case mgt, use of computer-generated evidence, attorney-client priviledge
Attorney-client priviledge. Expert witnesses. Case management. Sentencing. Work Product Doctrine. Using surveillance tapes in the courtroom. Introduction to Basic Legal Citation. Legal bulletins focused on the hospitality industry - applicable to most industries.


- Health Benefits / Health Care Quality : USQA Quality Reports. NCQA accreditation. CVO certification and more
JCAHO performance measurement ratings for healthcare facilities. USQA Quality Reports. NCQA Accreditation. HEDIS Report Cards. CVO certification. Health plan ranking reports.


- Terminations / Layoff Procedures : Industry layoff guidance, reports, laws
Weekly layoff reports by industry. Guidance on layoffs and labor laws. How to control excessive WC claims with layoffs.


- Updated Workers Compensation / WC Claims : Managing the costs of workers compensation claims
Reference sources to assist with managing workers compensation claims



Laws & Regs


- Human Resources / Layoffs : Industry layoff guidance, reports, laws
Weekly layoff reports by industry. Guidance on layoffs and labor laws. How to control excessive WC claims with layoffs.


- Updated Legal Topics / Insurance Law : Case developments, articles, resources related to insurance law
Analysis of court opinions involving insurance issues. Articles on commercial insurance, self-insurance and alternative market, etc.


- Legal Topics / Litigation : Legal case mgt, use of computer-generated evidence, attorney-client priviledge
Attorney-client priviledge. Expert witnesses. Case management. Sentencing. Work Product Doctrine. Using surveillance tapes in the courtroom. Introduction to Basic Legal Citation. Legal bulletins focused on the hospitality industry - applicable to most industries.



BuildingACES


- Ergonomics / Medicine : Clinical practice guidelines, patient handouts on low back pain, CTS, etc.
Medical diagnosis and treatment of ergonomic-related injuries. Clinical guidelines and primary care management of acute low back pain. AHCPR guidelines on acute low back problems in adults. Teaching module for physicians and health care professionals on low back pain . Carpal tunnel syndrome. Series of ergonomic medicine guides designed for patients that provide explanations & illustrations. Medical management in an ergonomics program. Painful shoulder diagnosis and treatment.


- Human Resources / Layoffs : Industry layoff guidance, reports, laws
Weekly layoff reports by industry. Guidance on layoffs and labor laws. How to control excessive WC claims with layoffs.


- Updated Legal / Insurance Law : Case developments, articles, resources related to insurance law
Analysis of court opinions involving insurance issues. Articles on commercial insurance, self-insurance and alternative market, etc.


- Legal / Litigation : Legal case mgt, use of computer-generated evidence, attorney-client priviledge
Attorney-client priviledge. Expert witnesses. Case management. Sentencing. Work Product Doctrine. Using surveillance tapes in the courtroom. Introduction to Basic Legal Citation. Legal bulletins focused on the hospitality industry - applicable to most industries.


- Workers Comp / Claims Management : Managing the costs of workers compensation claims
Guides to work-relatedness of occupational diseases. Activities to control disability costs. IME. How WC settlements are viewed in each state and the various forms of settlements. Cost and reserving guidelines for quadriplegia, massive injury, traumatic brain injury.


- Updated Workers Comp / Managed Care : Guidance on managed care in workers compensation to control medical costs
Challenging hospital and doctor costs. Entire text of the results of California's survey of workers compensation managed care practices.




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