As California officials are calling for a review of workers’ comp fraud fighting practices in the state, some cost containment providers are saying that bill review can be an effective tool for detecting fraud. Jason Beans, Rising’s Chief Executive Officer, shares some of the company’s bill review practices for detecting fraud.
Read Full Article on Work Comp Central (subscription required)
“Claims Advocacy” is fast getting the attention of workers’ comp claims leaders as a powerful approach to better claims outcomes. The on-demand economy has created cultural and multi-generational expectations around service, speed and simplicity – expectations that raise the bar for engaging injured workers. We found some claims leaders – from Starbucks, Albertsons Safeway, Nationwide Insurance, and Sedgwick – who have already figured out what to do. This article, co-authored by Rising’s Work Comp Benchmarking Study Program Director Rachel Fikes and industry journalist/consultant Peter Rousmaniere, uses interviews and study insights to describe the advocacy concept and how to walk the walk. Four minutes to read.
Federal health care regulators are paving the way for a value-based purchasing approach in workers’ compensation. Rising CEO Jason Beans outlines Medicare’s assertive advances to replace the fee-for-service model, their impressive outcomes, and takeaways for workers’ comp in his Risk & Insurance Risk Insider column.
Fraud analytics can help detect suspicious injury claims, fraudulent providers, and premium avoidance scams. In this article, Rising’s Work Comp Benchmark Study results shed light on the adoption of analytics by payers.
States that allow employers to choose a health care provider for an injured worker have a lower average medical cost per claim than states where employees can choose their provider, according to a study by Liberty Mutual Insurance. Anne Kirby, Rising’s Chief Compliance Officer & VP of Care Management, comments on the study findings.
Read Full Article on Work Comp Central (subscription required)
This article highlights key findings from Rising’s 2015 Workers’ Compensation Benchmarking Study. Rising’s VP & Study Program Director Rachel Fikes co-authors the piece with industry journalist and consultant, Peter Rousmaniere. Together they summarize the insights from hundreds of claims leaders on the state of claims management today and their strategic vision for the future.
Only in U.S. health care can you be charged for a service foisted upon you while unconscious. A different model could fix that. Rising CEO Jason Beans shares some thoughts on dishonest practices in healthcare, and how value-based purchasing can eliminate them in his Risk & Insurance Risk Insider column.
