A workers’ compensation claims professional along with a Risk or Claims Manager for a private or public entity should have a general understanding of the ancillary services that are available and utilized in the adjudication of a workers’ compensation claim. This course will provide information on what ancillary services are and how they are used. After completion, participants will be able to: understand types of ancillary services, explain why these services are necessary, understand when and how to utilize these services, gain a basic knowledge of how to manage ancillary services, understand what information is needed when making a referral and understand the costs associated with ancillary services.
Introduction to medical terminology and how to apply the medical terms to assist in the adjudication of workers compensation claims.
This course will enhance the knowledge on how to read and understand the medical terminology that is being used by the treating physicians, hospitals, etc. in medical reports and authorizations for treatment. Being able to understand the body part and injuries that are being treated will assist you in evaluating the future cost of the medical treatment and be able to evaluate the current treatment which will help in making sure you have the right reserve on the claim. In addition, the documentation of the plan of action for current and future treatment will be enhanced.
Course Objective: At the end of this course you should be able to understand the medical terminology and the part or parts of body that are injured and being treated on a workers compensation claim. You will also be able to understand how to use the medical terminology when adjudicating and evaluating a workers compensation claim.
Claims professionals need an understanding of when physical rehabilitation is appropriate in a Workers’ Compensation Claim. Understanding the terminology is extremely beneficial when determining the need for ongoing treatment and when it is beneficial. Understanding the terminology and individual modalities are beneficial to the clinical management of the claim.
Claims professionals should have training and knowledge of Medicare Set-Aside (MSA) and Center for Medicare & Medicaid Services (CMS) approval and when it is required. There are many steps and requirements necessary in order to protect the employer/carrier from future liability upon settlement of a workers’ compensation claim.