Note Type
Note Type
Note Type
Note Type
Note Type
100

Call to Linsey Vonn 888-999-1010 left message introducing myself and requesting return call regarding her 02/09/2010 DOI.

What is Claimant Contact?

100

Call to YouShoesyouloose location 444-864-2131 spoke with Store manager Frank Whoseimawhatsit the employee returned to work today 03/21/21 full duties 

What is Employer/Insured contact?

100

This is the note type you would use when providing an overview of litigation to date or to document no litigation in your initial date integrity note

What is Litigation?
100

This is the note you use to document the overview of medical treatment to date

What is Medical Management

100

4/13/2021 Northwest Community Immediate Care 847-618-9655

48yr old male presented to ICC toady to with bilateral upper arm pain which started 3 weeks ago. no injury or trauma but does heavy lifting at work. pain worse with lifting 

What is Medical report review?

200

Received bill from DOS 10/01/21 for PT reopening file for payment of previously approved therapy, file to be closed following processing of same  

What is reopen? 

200

This note type is for an item you must request and receive this from defense within 30 days of assignment and then quarterly

What is a legal budget?

200

Request sent to employer Kim Sanchez with Tek Corp for wages for 52 weeks prior to the 04/06/2021 DOI 

What is AWW/Comp rate?

200

CSR sent to Betty White with Golden Girls Co-op and copy to file next CSR due 07/29/21

What is Client Status Report? 

200

Request sent for clerical to sent new claim packet, EFT, and mileage for to claimant 

What is Claimant Contact? 

300

AWW:  $491.68  AWW Rate:  $327.79  PPD Rate:  $295.01

Received wage history. Year prior:  $16225.39 without OT $18445.13 / 33 weeks worked = $491.68.

What is Aww/Comp rate?

300

This claim does not meet the criteria for excess reporting reportable at $500,000 to Safety National

What is Excess?

300

Letter of representation received 02/21/21 from Curtis McPhail, Bickers and McPhail  PLC, 1095 Redline, Chicago IL 60663, 773-648-2131 C.mcphail@BMattorneysatlaw.com

What is Claimant attorney?

300

Any correspondence (including letters, emails, phone calls) with Defense counsel would be included under this note type.

What is Defense Strategy? 

300

Jurisdiction: Kentucky claimant lives, works in and injury occurred in KY

What is State/Regulatory Forms?

400

Adjuster response to supervisor review:

Correct the errors on the RTW screen-Done

Update the OSHA screen with the providers information-Done

Call the provider to obtain the next appointment date and update the file accordingly. Task set


What is File Review? 
400

There is a different template for Hartford high deductible or excess/SIR. 


Please see templates I couldn't fit it all on on here :-) 

What is Coverage/policy?

400

Request to clerical to sent form 1043 - IN (1043) Agreement to Compensation TTD

Date disability began 04/16/2021

AWW $ 1141

TTD $760.66

Weekly or Biweekly Bi weekly

What is State/Regulatory Forms?

400

File review with client (name parties present) 04/29/21 discussed file and agreed to move forward with offer of 20k, reserve increase provided to same. 

What is File Review? 
400

Defense counsel assigned, auth provided by client for same 03/16/21 Quilliam T Nibbles, Hedgehog and Whistlepig LLC, 333 Over the Hill Lane, Adventure MI 47321, QTNibbles@Lawforone.com

517-124-6791


What is Defense Attorney? 

500

Report sent to CHUBB by claim manager Karen Kenny 03/03/21, copy to file,  next report due 06/03/21

What is Excess note?

500

Email received from David Trammlel P atty (dtrammlel@deweycheatemhowe.com) indicating we can resolve this claim for $21,141.00 on all issues. The settlement represents approximately 6% MAW and 15% of the hand at a PPD rate of $348.00. If we agree he will send contracts

What is Claimant attorney?

500

All bills through 08/01/20 release date paid. File has settled 04/12/21. RX card closed. RTW updated. Closing claim

What is Closure? 

500
Use this note type code for Witness contacts, to address fraud, and Occupation  

What is Investigation?

500

Email with ER and bill attached  has been sent to the Bill review supervisor Teresa Gauze dated 04/22/21: Hi Teresa, we received this bill for D.O.S 12/30/20 from Community Hospital South the bill was zeroed out as a duplicate. This is not a duplicate bill and it needs to be sent through for processing. Please advised if this bill can be reprocessed for payment. Thanks.

What is Medical Bill Process