Worker's Compesation Adjusters Drowning in Claims [Infographic]

- THE YEAR OF THE ADJUSTER WORKERS' COMPENSATION ADJUSTERS are DROWNING IN CLAIMS WORKERS' COMPENSATION ADJUSTERS deal with a different level of complexity when compared to other types of insurance. More bills, more deadlines, more potential penalties and more people involved. Many adjusters struggle to close claims using systems that don't fit their needs. But through all of this, their dedication to getting the injured worker healthy and back to work remains undaunted. 62% HOSPITALS JOINING LARGER HEALTH SYSTEMS 38% PRESENT LAST 2 DECADES 1990's 2000's 2010's In the past two decades, the number of hospitals joining larger health sytems has increased from 38% to 62%, meaning claims handlers are increasingly dealing with sophisti- cated electronic billing systems. [2] A DAY IN THE LIFE OF AN ADJUSTER 2$ 20 An average of 20 bills from 6 differ- ent providers, plus 20 additional sup- porting documents per claim. [3] 130+ 24% BILLS OPEN CASES UNRELATED BILLS Handles at least 130 open 24% of submitted bills are incomplete, dupli- cate, or unrelated. [3] cases ata time. [1] 1 7,800 13,000 CPT CODES TO UNDERSTAND ICD-9 CODES TO BE AWARE OF There are 7,800 CPT codes used to describe different healthcare services that adjusters need to understand. [4] There are 13,000 ICD-9 (soon to be 68,000 ICD-10) diagnostic codes they need to be aware of. [5] ADJUSTERS [2] SPenD THE MOST TIME. 12) Following up with doctors and patients about medical visits 57% Tracking down medical documents 16% Sorting through & compiling bills related to the case 16% Confirming jurisdic- tional regulations 6% Other work 5% by more than an organization makes TECHNOLOGICAL CHANGES WHAT IF [3] 40% that could FREE UP an ADJUSTER's DAY [2] ADJUSTERS WOULD Use THAT EXTRA TIME TO. . . 38% 26% KEEP ALL PARTIES REVIEW RESERVES INVOLVED in the MORE OFTEN to case up to speed on how it is pro- gressing. make sure they were appropriate and close where possible. 19% 17% CONTACT PROVIDERS about FOLLOW UP WITH recent visits to collect INJURED WORKERS to make sure they are on track to get back to work. essential documentation or use the time in another beneficial manner. [2] * TOP 3 REQUESTS *** from CLAIMS ADJUSTERS in order *** to do their job better 3 THE ABILITY TO DETAILED CLAIM ELECTRONIC REFERRALS aT ELECTRONICALLY INFORMATION AND RAPIDLY YOUR DESKTOP enabling you to see every action taken in the claim archived and retrieved elec- COMMUNICATE including confirma- tion of scheduling and calendar notifi- cation. CLAIM STATUS to claimant, attor- ney and internal constituents. tronically at your desktop whenever you wish. CLAIMExpert "Your WORKERS' CompensaTIon PRocessInG PLATFORM" CLOSED 40% +11% 75% 50% Free Up 40% OF ADJUSTERS' Day CLose medical CLaims 50% FaSter 11 PoInTS AUTO- MeDical Loss ADJUDICATION ImPRovemenT [1] Poole, Jerry. "High-Tech Efficiency Wars" Claims Management Magazine.October, 2013. [2] Acrometis Adjuster Survey 11/13 [3] CLAIMExpert data 2001-2013 [4] "What is a CPT Code?" Officeof Physician Billing Compliance. Universityof Florida Health. [5) "The Differences Between ICD-9 and ICD-10". American Medical Association. September 2012. Information powered by: ACROMETIS' www.acrometis.com