Investigation
This is where information regarding subrogation potential is initially documented.
What is Summary / Claim Status / Subrogation Status?
This is where the wage information is housed, once obtained.
What is Loss Details / Benefits / Compensation?
In order to calculate the BMI for an injured worker, these are the data integrity items that must be entered.
What is, the injured worker's height & weight?
These are the three available loss lines within the reserve worksheet.
What is Indemnity, Medical, and Expense?
This is the email address wherein mail can be sent, and you will receive an activity once it hits the claim.
What is claimsmail?
This is where they Kind of Disability (MO, TP, TT, PP, Death) is housed in Claim Center.
What is Loss Details / Details tab / Kind of Disability?
This is where information regarding a change in the injured worker's work restrictions, or changes in the employer's ability to accommodate given restrictions are captured.
What is Loss Details / Benefits / Work Status?
This is where an expiration date should be entered before claim closure is completed.
What is Medical Management / Medical Summary / Prescription Management / Expiration date?
This is where we reserve for anticipated mileage reimbursement requests from the injured worker.
What is Medical / Travel?
This is the email address you can copy on incoming or outgoing correspondence to have a copy of the email, and all attachments sent to the documents, but NO activity will be generated.
What is csc backload?
This is where the determination regarding the compensability of the claim file is located.
What is Loss Details / Benefits / Compensability Decision?
This is where information regarding the injured worker's disability status is housed.
What is Loss Details / Benefits / Benefit Status?
This array cannot be completed unless Parties Involved has been updated first.
What is Medical Management / Medical Summary / Independent / Expert Evaluations?
This is where we reserve for anticipated billing associated with an Independent Medical Examination.
What is Expense / IA/Experts?
This is where a settlement should be coded to ensure no further bills are paid on this particular claim.
What is Loss Details / Details / Resolution?
This is where the initial submission of the claim to ISO is initiated, and where matching search results can be reviewed.
What is Loss Details / ISO Claim Search?
This is where information is housed to show the type of disability, as well as the estimated and actual lengths of disability.
What is Loss Details / Benefits / Length of Disability?*Will also accepted Loss Details / Benefits / ELOD/ALOD?
This is the field that should be updated if you find out your injured worker has been treating for high blood pressure.
What is Medical Management / Medical Management / Comorbid Disability Factors?
This is where we reserve for vocational rehabilitation, if applicable for this claim.
What is Indemnity / Voc Rehab?
These are the three MAIN data integrity items the Comp Validator tool reviews to determine whether a payment is issued, or if the claim is dropped to Shield for review.
What is the Compensability Decision, the Body Parts array, and the Care Control plan?
This is where the Claims Professional must go to update or input the injured worker's email address.
What is Loss Details / Details / Injured Worker's Name Hyperlink / Email? OR What is Parties Involved?
This is the field that will be updated on a claim if an injured worker becomes eligible for Medicare.
What is Loss Details / Section 111 / CMS Eligible?
This is where utilization review reports are automatically updated, upon receipt.
What is Medical Management / Care Control / UR Summary?
This is where you must go to "reveal" the indemnity loss line if the claim was originally set-up as a medical only file.
What is Loss Details / Details / Kind of Disability?
This is the name of the "rule" we build when a customer has unique and specific billing requests, as it relates to how a bill is paid.
What is a "Pathway" rule?