Success Stories- 3
Referral to a Treating Physician
An employee filed a claim for a back injury. She was receiving treatment from her own chiropractor and was found to have aggravated a pre-existing condition and was out of work. Upon our request, she was seen by a member of the employer’s doctor panel. After this she was able to return to work on light duty.
No Losses Left
During a loss run review a client had one open claim with a medical reserve of $6000 and an indemnity reserve of $5000. We discovered that this claim was over a year old and we contacted the insurance company on their behalf and the claim was closed. If this claim had remained open with the $11,000 reserve total, their experience mod would have increased 20% to well over 1.21.
Outstanding Medical Bills
A client’s employee had surgery due to a back injury. This employee began receiving collection notices for two outstanding medical bills. We contacted the insurance company on behalf of our client to resolve these issues. The insurance company did not pay the bills because they stated they were not related to the back injury claim. Upon further research it was discovered that one bill was not paid in error and the other was related to leg pain, which according to the medical report and doctor, is a common healing pain for back surgery. Both bills were ultimately paid by the insurance company.