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Customer Experience
Know your MDP
LNAV
Team
Company
100

What we do day 1 when claim assigned

Call insured, advise role, advocate for them, set expectations

100

This is the CPT code for Therapeutic Exercises and what we review to confirm we can pay it all

97110, review the units billed VS times

100

2 types of claims where LNAV is not eligible

  • UM / UIM features
  • Fatalities
  • Claims clearly valued in excess of policy limits
  • Open reductions of any weight bearing bones (with or without internal fixation)
  • Where primary claim is a dental injury
  • Internal injuries
    Examples: Punctured lung, organ damage, subdural hematoma / hemorrhage
  • Multiple serious injuries to 1 individual
  • Disk injuries with surgery
  • Some timely settlement opportunities
  • All soft tissue injuries, for example, neck / back sprain strains, all other “minor” sprain / strains, contusions, and/or abrasions, with fewer than 4 LNav-eligible medical visits

    • LNav-eligible medical visits should only be counted when person is receiving evaluation or treatment
      Examples: medical evaluation by provider, therapy (PT / Chiro), injections

      • GP / ER / TS visits only LNav-eligible for neck back soft tissue injuries

      • Diagnostics only, for example, X-Ray, MRI, CT scan, would NOT be counted towards the 4 medical visits

  • Injuries caused by exposure to pollutants / hazardous materials
  • Claims where majority of value cannot be evaluated by LNav
  • Claims where full injury evaluation high is $100,000 or above
100
"Good Kid, Maad City" is the JAM for this rep

Miguel

100

Our latest Gainshare factor

1.88

200

This is the % DID calls metric we use to gauge phone behaviors

% DID calls to VM under 30

200

Radiology CPT procedures usually begin with this Number

what is 7

200

What is an example when we do not code a shoulder sprain

Unlikely Separate Shoulder Injury

Likely Distinct Shoulder Injury

  • Rear-end impact
  • Bilateral shoulder pain
  • Trapezius pain (neck)
  • Inter-scapular pain (thoracic) 
  • No ROM testing
  • No arm immobilization or restrictions in activity
  • No imaging performed
200

This rep's guilty pleasure is Jack in The Box's tacos

Bri

200

List at least 3 of our 5 Core Values

Integrity, Golden Rule, Obectives, Excellence, Profit

300

This is the average hours expected for VM callbacks

20 hours

300

Electrodes are usually not considered as they are built into other CPT codes. What letter do they usually start with?

A

300

Scarring and Disfigurement is considered in additional damages, True of False? 

False. They will be included in its own section in LNAV.

300

Has a collection of Labubu's

Brittany

300

What is our Vision Statement

Our Vision—to become consumers’, agents’, and business owners’ No. 1 destination for insurance and other financial needs

400

When a demand is received, this should be done same day with our insureds

Call them, advise demand, will send excess, and try to have them rest assured we are here to help resolve this.

400

Where can you find the date the bills were completed so you can meet the requirement of evaluation with 7 days of MDP completion

Commited on date appears at the top left usually in blue

400

Three levels of Sprain/Strains and when do you code each?

I. Minor Sprain / Strain: Ligament stretched, no tear, little to no treatment.

II. Moderate Sprain / Strain: Diagnosis of partial tear with treatment and possible immobilization.

III. Severe Sprain / Strain: Complete tear or partial tear with surgical recommendation.

400

This is Ozriks favorite Energy Drink

Reigns

400

What is our Purpose

We exist to help people move forward and live fully.

500

This emotion is the ability to understand and share the feelings of another person. 

Empathy

500

ESI and MBB injections CPT codes usually being with this number

6

500

When deciding to use Treating Specialist, what should be documented in your BIE

Document the TYPE of provider that was seen

- DO

- Ortho Surgeon

- Neurologist

500

At one point, Jason had this type of exotic pet. What is the name of the breed?

Fennec Fox

500

The name of the insurance company Progressive will be replacing soon a #1 in the US

StateFarm