Utilization Review: Phone Tag, but With Fax Machines

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The leaps in technology used for medicine is staggering. In the past few years, machines like the High Intensity Focused Ultrasound (HIFU) show how cancer cells can be eliminated using sound waves alone. Every day, a new breakthrough has been found, or is in the process of testing.

… but it still takes doctors up to a month to speak to each other in order to get a patient the treatment that they need for their workplace injury.

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The Astronomical Costs of California Work Comp, Explained

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California is a desirable place to live. Is known for its dynamic landscape, unique flora and fauna, access to the Pacific Ocean, temperate climate, etc. As long as California has been charted, media like movies and music have touted the marvels of the land. On top of all of this, the state is an economic giant for entertainment media, agriculture, and tech.

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On-Site Clinics: How They Help Workplaces, Corruption, and What to do if Your Claim is Being Wrongfully Denied

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Some companies are so large that it benefits them to have a medical clinic on-site, in order to handle first-aid, routine check-ups, and workers’ comp injuries in-one.

Job sites like large offices and construction sites have chosen to use on-site clinics due to a range of benefits for both employer and employee.

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Grading Your Reports: Data Integrity, Completeness, and Quality

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Imagine that you were able to know whether or not your claim was going to drag out due to errors in writing workers’ comp reports. How much time would it save you to go back and correct a few simple mistakes?

Data Integrity, a unique feature of RateFast, does exactly that.

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Nurse Case Managers in California Workers’ Comp

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We’ve now mentioned the many different stakeholders that can enter a workers’ comp claim. The stakeholders in any and every work comp claim are the injured worker, the PTP (Primary Treating Physician), and the insurance adjuster. In California, if a claim gets tricky, an attorney and a QME can join the claim.

Still more stakeholders can join the claim in order to help things along. The nurse case manager is one such stakeholder.
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RateFast Definitions: PTP (Primary Treating Physician)

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A PTP is the Primary Treating Physician of a workers’ comp claim. When an injured worker’s claim is approved by an insurance company, they are either assigned or given a choice of a physician who will provide care, request treatment, and recommend specialists for examinations during the claim. The PTP also has the job of writing the impairment and permanent stationary reports for the claim, which determines how money the worker is compensated.

The PTP is a physician that is within the MPN (Medical Provider Network) of the insurance company. Generally, an insurance company will assign a PTP to a worker based off of proximity and specialty in relation injury.

If you are a worker who was recently injured and are confused or have questions about the workers’ compensation system in California, see part 1 and part 2 of the Worker’s Guide to Worker’s Comp series.
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Workers’ Comp Fraud: It Isn’t Worth the Consequences

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Every week, several news stories surface about another person, or group of people, being caught for workers’ comp fraud. Those are just the stories that are being published. While it may be true that there are still people getting away with it here and there, this people are just one investigation away from dire penalties.
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A Worker’s Guide to Workers’ Comp Part II: Making the Most of Your Injury

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If You Need Emergency Medical Assistance, Dial 9-1-1

This guide is intended for employees who wants to know what to do if they sustain a workplace injury or illness. This article series goes beyond the moment of injury, and gives a picture of what to expect when choosing a doctor, getting treatment, and beyond. This guide is specific to California, but many of the steps described cross state lines.

This is the second part of the series covering what a worker should do in the event that they have suffered an injury or illness in the workplace. If you have recently been injured or have fallen ill due to an event or conditions at work, and have not yet filed a workers’ compensation claim with your employer, please see part 1 of this series. If you have filed a workers’ comp claim with your employer, read on.

Now that your claim has been filed with your employer, there are still steps that you must take to ensure that you receive your benefits (and partial pay for time off work, if applicable). This the beginning of your journey through the workers’ compensation system.
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