AgdaPkt 2002-01-28 - Laserfiche WebLink

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7. Maintain a list of credentialed, medical specialists who are familiar with workers' compensation regulations and requirements. 8. Evaluate all medical reports for potential to involve the injured worker in a modified duty, early return to work program. 9. Review and audit all bills, reducing them to below the Official California Fee Schedule (OCFS) and per HMC's PPO contracts. Cost Control 1. Employ all of CMI's cost control programs, including: · Medical Cost Management · Claim File Management · Modified Duty, Structured Return to Work Program · Litigation Case Management · Legal Cost Management · Rehabilitation Cost Management · Subrogation Reimbursement · Excess Insurance Reimbursement 2. Determine if subrogation is possible, obtain all necessary documentation; persist in collection efforts, coordinate all activities with legal counsel, and send final reports to the Client. 3. Pursue early, creative settlements to close cases appropriately. 4. Close all medical only claims within sixty (60) days of the last payment made on the claim. 5. The examiner will attend Workers' Compensation Appeals Board hearings. 6. Prepare and submit informal ratings when medical reports indicate a permanent and stationary status. Services to Injured Workers 1. Promptly provide written information and guidance to unrepresented injured workers regarding their rights, benefits, and status as each case matures. 2. Follow-up all verbal employee contacts in writing. 3. Visit various department locations and meet with unrepresented injured workers to resolve concerns and show the Client's interest in them. 4. Develop and recommend policies and procedures to ensure 'that the injured worker's physical capabilities are correctly matched to an appropriate work plan, avoiding further injury. PA~E 9 CLAIMS MANAGEMENT, INC.