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.
Adjusters Send Back Bad Reports
A doctor writes reports for each visit that an injured worker has in their office. This report includes things like how the injury is coming along, as well as requests for treatment for the injury. If the report is badly written, the insurance adjuster can (and often will) send it back, and wait for the doctor to write a better report. This is a very, very common problem in workers’ comp.
As we mentioned before, reports that are sent back can result in prolonged claims, piling bills for the injured worker, and possible legal action[link when should i get an attorney].
The solution to the issue is feedback and accountability. When a doctor has an idea of how well their report was written before they send it to the insurance adjuster, they have the opportunity to correct their mistakes, saving them additional hours, weeks, months, even years of unnecessary work.
Data Integrity: The 10,000 Foot View
Just like assignments in school, RateFast gives you a grade based on how well your report is written. This is what we call Data Integrity. Data Integrity is the final grade determined by two factors in the report: Data Completeness, and Data Quality.
When RateFast evaluates your report, we will return the results as a letter grade from A to F, as well as a percentage of integrity based off of our calculations.
The Pillars of Integrity: Data Completeness and Data Quality
When your report is submitted to RateFast, it is first screened for Data Completeness, or how much of the data required for the injury is included in the report. If a physician treats an injured worker for a herniated disk, RateFast scans the report for how much data the doctor provided based off of the state’s specific workers’ comp rule set (in California, this is the AMA Guides 5th Edition). The completeness of the report is determined in percentage, and then rated for quality.
Data Quality looks at how well the data given was written. Does the report simply say that “The disk still hurts,” or are all measurements taken with the appropriate tools. Was the range of motion for the herniated disk measured with a dual inclinometer?
Once the completeness and quality are determined, RateFast calculates the Data Integrity. The integrity is a letter grade based off of the percentage of completeness and accuracy.
A Low Grade isn’t Necessarily a Bad Thing
We mentioned that poorly written reports are a very common problem in workers’ comp. This is fortunate for almost any doctor looking to improve the integrity of their reports because frankly, the bar is set pretty low.
If your report was returned with a C+ integrity score, it doesn’t mean that the report is likely to be rejected, though an A+ score is much more likely to be accepted, by comparison
What if the Report is Sent Back Anyway?
RateFast is a tool that is built by people with over a century of combined experience in workers’ comp. If your report is sent back citing reasons of not being complete or accurate, RateFast will re-evaluate the report for you. Rest assured, this isn’t a problem that the A+ doctor will face often. We have a track record of excellence in workers’ comp.
In the end, the final say of the accept-ivity of a report comes down to the stakeholders willingness to accept the level of (completeness and data quality) integrity and the delivered results. The data integrity feature of RateFast helps focus energy and resources on understanding what is and isn’t there, of course, RateFast takes care of the data set rating accuracy as always. If you are a stakeholder with interest in better understanding what your are looking at in impairment reports, contact us for more information on impairment rating integrity analysis.
We understand that being part of a work comp clinic means taking on hard work. The Data Integrity tool is meant to enrich the workload that is already there, in fact saving you time by evaluating the work that was already done before it’s too late.
To learn more about Data Integrity and Data Set Completeness, listen to what RateFast creator Dr. John Alchemy has to say on our podcast, the California Work Comp Report.