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3 page executive report describing how information technology impacts California Workers' Compensation Industy - Essay Example

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Workers’ compensation is a network of state-run programs that provide medical care, indemnity benefits and rehabilitation services to workers who suffer work-related injury or disease. Reforms have been undertaken by various states to reduce costs. In California for instance,…
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3 page executive report describing how information technology impacts California Workers Compensation Industy
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Download file to see previous pages Information technology and its benefits have not yet been fully employed in the workers’ compensation industry although several instances of it are available. Providers have been using the EDI but the process is still a challenge in the workers’ compensation industry. The workers’ compensation is such a small part of the claim that many providers have yet to start with electronically processing of claims.2
The technology that is used in the industry is P2P link which provides an electronic “transaction hub” which allows information to be shared between payers and providers. The providers can submit bills, medical reports and other communication through web interface. An automated review checks the bill for accuracy and completeness before it reaches the insurance carrier for payment. This is in use at Lakeland which improves the flow of information and streamlines the adjudication of claims. It has improved the ability to execute the payment of workers’ compensation claims in a timely manner. While other states use the American Medical Association guidelines to ensure fair evaluation of physical impairment, California lags behind.
The California Workers’ Compensation System (CWCS) is in the grip of crisis as doctors are leaving by the dozen. Doctors are dropping out because of the delays in reimbursements for treatments.3 Patient loads have doubled while treatment authorization takes months. The new SB 899 had become effective in 2004 but is now under severe scrutiny for the human suffering it has caused. Nobody in the state administration is concerned as the insurance company profits are soaring.
The faster an insurer receives notice of an injury, medical treatment can be initiated timely, the injured starts recuperating fast and gets back to work. This would eliminate the cost of hiring an attorney to settle claims. This is where ...Download file to see next pagesRead More
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