Case Update
What should be updated in the case manager's tab?
Name, phone #, ______________
Email Address
When you begin working on a claim for an update, what is the first thing you should do?
Check Ligare's Portal
You discover during follow-up that the claim is workers' compensation. What should happen immediately?
A. Keep working it as regular no-fault
B. Escalate it immediately
C. Put it aside with no note, work on it after completing your entire list.
D. Close it as paid
Correct answer: B
B. Escalate it immediately
The person filing the complaint with the court (the injured party)
Plaintiff
You are about to call on a no-fault claim with nothing prepared except confidence. What should you have in front of you first?
A. Patient name, claim number, and DOA, DOS
B. Your favorite snack and a sticky note
C. Only the patient's last name & Claim #
D. The provider's zodiac sign
Correct answer: A
Patient name, claim number, DOS and DOA
What questions should you ask during a case update?
Confirm R&B, Case Status, _____________
Docket # & Venue
If you call and ask for a docket number but the attorney does not provide one, what should you do?
Document that you asked for it but had no luck getting that information
You discover a claim is workers’ comp, but the previous note only say “WC.” What is missing?
The next step and contact details
Should include, contact details, WC company, That the claim was escalated.
The court's official identification number for a case
Docket Number
What is the best opening question when calling to check a no-fault claim?
A. "Did yall ever pay this?"
B. "I am calling to check the status of a claim for John Doe. Could you please provide the current status?"
C. "What is going on with this claim because nobody ever answers?"
D. "Can you hurry this up for me?"
Correct answer: B
"I am calling to check the status of a claim for John Doe. Could you please provide the current status?"
Why should we avoid sending multiple case update request to multiple CM at once?
BONUS DOUBLE POINTS
To avoid confusion and to help the CM identify which cases belongs to them.
Why is it important to document even when you don’t receive an answer from the attorney or case manager?
To show all contact attempts/provide a timeline of outreach
BONUS
Why is workers' comp escalation important?
*DOUBLE POINTS*
A person appointed legally to act on behalf of the plaintiff or defendant (a.k.a Lawyer)
Attorney
You call on a claim and the rep says payment was issued last week. What is the best next step?
Confirm payment amount, date issued, payee, and mailing address or payment destination
If you call for an update and reach the case manager's voicemail, what should you do next? Or what resources should you exhaust next?
Send an email, check court site
You call and the paralegal tells you the case is still active, but the court site shows 'dismissed.' What should you do next?
Inform the CM of what you found on the court site/ask for more info regarding the discrepancy.
What contact information should be requested on a workers' comp claim?
Case manager name, phone, email, claim # and the workers' comp company name
process to obtain evidence before trial (this is done in the litigation stage)
Discovery
The rep says the claim was denied. What is your best next question?
Correct answer: A
Why was the claim denied ?
BONUS
700 Points
If you come across court records that state the case is settled, what should you do?
Give details (walk me through your process)
Attorney XYZ Law Firm has emailed stating a claim is "dropped" what should you do next?
Ask why the case was dropped
Is there new attorney info on file(**Check court sites, provider portals for different/updated attorney info)
Which note is best after learning the claim is workers' comp?
MUST include
Case is WC
Case was escalated
CM contact info
WC Company info
Claim #
time within which a lawsuit must be filed
Statute of Limitations
What is a major difference between an LOP claim and a no-fault claim?
No-fault usually goes through auto/PIP coverage, while LOP treatment is typically tied to attorney-directed payment protection