Author Archives: Helen Knight

Tower MSA Partners’ New MSP Automation Suite Proactively Drives MSP Compliance and MSA Preparation

Delray Beach, Florida (January 25, 2016) — Tower MSA Partners has rolled out its comprehensive MSP Automation Suite. The sophisticated technology drives all the processes Tower has perfected to proactively manage Section 111 Mandatory Insurer Reporting, the recently implemented Conditional Payment Notice process, and to stage workers’ compensation claims for Medicare Set-Asides and closure. 

“Essentially, it automates our best practices for Medicare Secondary Payer compliance, claims optimization and MSA preparation,” said Tower CEO Rita Wilson.

Tower distinguishes itself by reducing medical and pharmaceutical costs before preparing MSAs.  “Our Pre-MSA Triage identifies barriers to settlement and recommends claim-specific interventions, like physician peer review and clinical oversight, to remove those barriers long before preparing an MSA,” she added.

The MSP Automation Suite can track a claim from Medicare beneficiary identification through final settlement. It records every claim activity performed by Tower or its network of practicing physicians and pharmacists and provides clients with 24/7, end-to-end visibility into claims. The system prompts for missing data, conditional payment searches, and medical/pharmaceutical interventions and sends electronic updates to clients at appropriate data points.

“Clients don’t need to manually diary activities or call to check on things,” Wilson said. “The system shows exactly when a phone call was made and follow-up is due.”

The MSP Automation Suite seamlessly integrates data from all types of claims systems and client business rules can be imbedded into the software alongside Tower’s rules for true business process management. “Automation frees claims professionals to address issues that require a human touch,” Wilson said.

About Tower MSA Partners

Headquartered in Delray Beach, Fla., Tower MSA Partners’ services include pre-MSA Triage, MSAs, physician peer reviews, conditional payments, Section 111 reporting, CMS submissions, MSA administration, medical cost projections, and life care plans. With more than 50 years combined experience in pharmacy, legal oversight and medical care, Tower proactively stages claims, working collaboratively with clients to identify issues and intervene to modify outcomes and remains involved in claims through final resolution. This model enables Tower’s clients to provide better care to injured workers, reduce claim and MSA costs, and obtain CMS acceptance of the MSA. For more information, visit www.towermsa.com and www.mspcomplianceblog.com.

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Media Contact:  Helen Patterson, King Knight Communications, 813-690-4787; helen@kingknight.com

Joseph McCullough Joins MedRisk

King of Prussia, Pa. (November 10, 2015) — MedRisk, a leading managed care company specializing in physical rehabilitation and diagnostic imaging in workers’ compensation, has named Joseph McCullough Executive Vice President of Customer Solutions.

He will be responsible for the development of new customer-focused solutions that improve the quality of healthcare, reduce medical costs and deliver operational efficiencies.

“MedRisk’s commitment to delivering effective solutions in a constantly changing landscape requires talent, leadership and an in-depth understanding of the workers’ comp community,” said MedRisk CEO Shelley Boyce.  “Joe’s experience in building successful workers’ comp specialty programs makes him a strong addition to our management team.”

McCullough has more than 10 years’ experience leading healthcare companies, most recently as president of OneCall Transportation + Language.  He also served as senior vice president of Optimal Care, the MSC division of Transportation and Language. In addition, McCullough is the former CEO of ZoneCareUSA and Select MRI prior to their acquisitions.

“I’ve admired MedRisk’s industry innovations for years and am excited about being part of this dynamic, customer-centric company,” said McCullough.

About MedRisk
MedRisk is the leader in physical rehabilitation and diagnostic imaging solutions for the workers’ compensation industry. Founded in 1994 and based in King of Prussia, Pa., MedRisk is accredited under URAC for utilization management and has successfully completed a SSAE 16 Type II examination. MedRisk’s programs deliver savings and operational efficiencies that are significantly greater than traditional programs. Customers include insurance carriers, self-insured employers, third-party administrators, state funds, and case management companies. To make a referral or obtain more information, visit www.medrisknet.com or call 800-225-9675.

 

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Media Contacts: 
Helen Patterson, APR, King Knight Communications, 813-690-4787; helen@kingknight.com
Rommy Blum, MedRisk, Inc., 800-225-9675 ext. 1150; rblum@medrisknet.com

 

 

PRIUM’s Mark Pew to Speak at the National Workers’ Compensation and Disability Conference & Expo

Pew and Walmart share its opioid management success story; then he discusses trends in urine drug screening with CWCI’s Alex Swedlow

Las Vegas, Nevada (November 3, 2015) – PRIUM’s Senior Vice President Mark Pew will participate in two sessions at the National Workers’ Compensation and Disability Conference & Expo.  The conference will be held at Mandalay Bay in Las Vegas, November 11 through 13. 

Pew and Walmart’s Director of Workers’ Compensation Janice Van Allen will share how the retailer used lessons it learned from reducing opioid misuse in legacy claims to develop a data-driven methodology for preventing drug misuse on new claims.  The interactive session, which starts at 2:30 p.m. on Wednesday, November 11, will provide prescription drug mitigation strategies, metrics for measuring success, and foundational principles to consider when creating an early intervention program.

“PRIUM helped Walmart create a program to address dangerous drug regimens that changed people’s lives,” Pew said.  “Beyond reducing the use of dangerous drugs and creating preventative measures for future treatment, they established a workplace culture of transparency that is to be envied.”

On November 12, at 2 p.m., Pew and California Workers’ Compensation Institute President Alex Swedlow will discuss trends in urine drug screening. Swedlow will review the latest CWCI research on the practice of urine drug screening. Pew will share best practices for urine drug management, its place in a full strategy for ensuring proper medication use, and how testing can help provide better care.

To read more about these presentations, please go to http://tinyurl.com/PRIUMNational

PRIUM will also exhibit at Booth 239 at the conference. 

About PRIUM

An Ameritox solutions provider, PRIUM sets the industry standard for workers' compensation medical interventions through its ability to secure higher agreement rates and ensure compliance with modified treatment plans. The hallmark of the medical intervention company's success is a collaborative physician engagement process encompassing evidence-based medicine, clinical oversight, and jurisdictional guidelines to ensure optimal financial and clinical outcomes. PRIUM eliminates unnecessary treatment through a comprehensive approach that includes complex medical interventions, utilization reviews, and independent medical exams.  Based in Duluth, Ga., PRIUM can be reached at www.prium.net or 888-588-4964.

 

Website: www.prium.net

Blog: www.priumevidencebased.com

linkedin.com/in/markpew

Twitter: @PRIUM1 and @RxProfessor

 

 

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Contact:  Helen Patterson, 813-690-4787, helen@kingknight.com

 

 

Building trust

Only 19% of Americans say they trust the federal government, according to Pew Research. The report says that the highest trust levels occured during the Cold War and just after 9/11. (Nothing like an enemy to unite us behind Uncle Sam.)

So what is trust? Dictionary.com's first two definitions are: 1.reliance on the integrity, strength, ability, surety, etc., of a person or thing; confidence and 2. confident expectation of something; hope.  

The federal government has many disparate agencies with different agendas and communicators, making any trust-building effort extremely difficult. Government representatives say different things…let the refugees in, vet them better, we can't adequately vet Syrian refugees. Who do you believe – the FBI or the executive branch? 

This is an organization that can't protect its own employees' data from computer hackers.  It's hard to instill "reliance on the ability" in this environment.  

Fortunately, your company is not as big and unwieldy as the government.  You can secure your public's trust through sound public relations: saying what you're going to do–and doing it–and then communicating what you've done. Whether it's delivering high-quality health care to an injured worker promptly, shipping a sweater on time or making sure the meat you're serving is free of e. coli, you demonstrate integrity. Words are important, but they aren't enough.  Action is what counts.

Here are some suggestions for building trust in your organization.

  • Identify the organization's mission
  • Clearly communicate the mission and your plans for executing it.
  • Make sure your actions (and products and services) support the mission.
  • Align all communications around your core message
  • Do things the way you promised you would
  • Say you're sorry when things go wrong,  take responsibility, explain what you'll do to fix problems, then give the outcomes when the problem has been corrected
  • Let your audience know the good things you're doing

You should continually review your products and services and how they're delivered against your core business ideals. I've known smart companies to jettison tangential product lines that took their focus off their core businesses. ​It takes time and consistency to build trust, and just one "isolated incident" can damage it if is not handled correctly.  Acknowledge and correct problems quickly. Don't over-promise and under-deliver. 

Actions speak louder than words; do the right thing the first time so you don't endanger the public's trust or have to spend a lot of resources cleaning up your mistakes.

 

 

 

Proper pronunciation make you look smarter

I've noticed some people with excellent vocabularies regularly mispronounce certain words.  I attribute this to them having read the words, but not hearing them used much.  

I'll always remember my friend Jeanne Dillard correcting our high school algebra teacher's pronunciation of some word (which I've forgotten.) Mr. Bates always said the word wrong. Jeanne has a great ear and a love for words (and a master's in linguistics and she is a successful novelist).  So she gently said, "Mr. Bates, I believe the word is pronounced "xxxx."  He turned red and sputtered, "Well either pro-nown-ciation is correct."  

The correct pronunciation makes you look smarter – at minimum people don't have to stop listening to you to mentally correct the sound.  (And they do–especially those linguists among us.)

So, here is a great post on mispronounced words.  Some of them surprised me – incluing niche – I've been "nitching" that one.