CMS Recovery Thresholds Update
1 MIN READ
Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the Medicare Set-Aside services Genex provides.
Overview of the 2019 Texas Department of Insurance Workers’ Compensation Network Report Card
5 MIN READ
The Texas Department of Insurance recently released its annual Workers’ Compensation Network Report Card. The 2019 Report Card includes medical cost and utilization measures for 17 workers’ compensation health care networks (HCNs), including the Coventry HCN, First Health HCN, and several other HCNs supported by Coventry. Various measures were calculated for injuries occurring between June 1, 2017 and May 31, 2018.
Pharmacy Nurse – When specialized attention is what’s needed
3 MIN READ
Workers’ comp pharmacy costs represent approximately 18% of total medical spend. That translates to $5 billion in pharmacy spend nationwide.1 Most employers and payors utilize Pharmacy Benefit Managers (PBMs) which offer an excellent line of defense in managing these ever-increasing pharmacy costs. But PBMs, by design, only manage the pharmacy related aspects of a claim. What if you could extend the reach of your PBM by combining it with the knowledge, care and one-on-one delivery model used in case management? With a pharmacy nurse, you can.
AASCIF Annual Conference
The AASCIF 2020 Annual Conference will bring together state funds from across the country for an event full o
Catastrophic Case Management: Immediate coordinated response by clinical experts
2 MIN READ
Most illnesses or injuries progress well with traditional case management services. However, a small percentage of cases require more intense and careful management. Early intervention and proper procedure are imperative in the treatment of catastrophically injured people. Clinical situations that require catastrophic case management are characterized by diagnosis, complexity of treatment, and high dollar exposure.
Medicare Secondary Payer Updates
2 MIN READ
Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the Medicare Set-Aside services Genex provides.
Spread the Kids’ Chance Mission
2 MIN READ
November 11-15, 2019 is Kids’ Chance Awareness week. It’s a time to highlight and raise awareness of this ever-growing organization that provides educational opportunities and scholarships for children affected by workplace injuries. Coventry is a proud supporter of Kids’ Chance of America and actively participates with many of the organization’s state chapters. Earlier this year we created a first of its kind Catastrophic Care Referral Program designed to refer affected parties directly to Kids’ Chance. The program provides a monthly report that flags eligible cases where the injured worker is gravely injured or killed in the course of a work-related accident.