Attack Lien Issues with RPM – Lien Resolution & Litigation

Published by admin on March 7th, 2012

Last February, the Insurance Journal reported that liens were “choking” California’s workers’ compensation system, with employers and insurers spending roughly $200 million per year to handle medical liens, according to a January 2011 CHSWC report. The report estimated that approximately 450,000 more lien claims would be filed in 2011.

Now, a year later, not much has changed. Lien claim procedures are so complicated and backlogged that case outcomes are often decided by procedural error rather than case merits – and while legal costs continue to rise, the legal maneuvering is reactive; accomplishing little but added expense.

In the past, litigating liens has been a costly proposition, requiring hours of legal fees for preparation, pre-trial, trial, and post-trial.  That is … until now.

Now, RPM is taking LIEN RESOLUTION one step further by expanding our LIEN LITIGATION SERVICES to confront lien issues, and battle them from cradle to grave!

That’s right! If we are unable to negotiate a lien settlement, we will take the case to trial on your behalf.  You no longer have to incur or endure uncapped legal fees – some reaching $4,000 or more to take a lien to trial. Our specialized lien litigators handle everything. We are street smart and TOUGH. We don’t roll over when faced with lien challenges. Best of all, you’ll save 50% or more on litigation costs by working with RPM.

We already know the claims issues (averaging 15 + years of claims experience), settlement strategy, and bill review complexities (litigation handled by certified bill reviewers). We also know the nuances of every California jurisdiction. Liens are our core focus. And now, we will resolve or litigate the lien, cradle to grave.

Whether you’re a carrier, self-insured employer, or a TPA, cost control is crucial. Take a bite out of your lien costs with ONE TOUGH LITIGATOR on your side. Put RPM lien resolution and litigation services to work for you.

Ready to refer a case, or learn more about this new service?
Use our case referral form online, or email us.

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Posted in California Lien Resolution, Lien Litigation

7 Secrets (Rules & Principles) To Growing Your Business

Published by admin on November 18th, 2011

By Byron Kerns, President of Resolution-Partners – As seen in the Comp Marketer Newsletter, November 2011

Is there a secret to growing your business? In a word – no, but there are sound principles that, if honored, will help you grow your business base quickly and strengthen your business’ foundation, while maintaining your business identity.

First Things First — This will sound too simple, but you need a good or great product or service; something that truly solves a problem (hopefully long-term), and that you believe in to your very core.

Incorporate – Incorporate your business as soon as you commit to growing. As a sole proprietorship, you can function and serve a few clients, but to protect your clients and limit your business liability, incorporate through an attorney or other legal service.

Always maintain your existing relationships – Like your high-school friends, these relationships can be the bedrock of your business and should never be compromised, even as your focus and energy shift to new ventures and opportunities. Finances and time – both are necessary to pursue new business, but keep part of your budget (and time) to ensure that your existing clients are being served.

Maintain Your Core Focus — Whoever coined the phrase “know what you do, do what you know” had a great point. I take this to mean “stay loyal to your core services(s)”. As they take off, many companies try to become all things to all people. This may help you to grow quickly, but may cause your customers to suffer while your business climbs the learning curve. In the end, all parts of your business might suffer. Stay true to your core service(s) and build from there.

Marketing / Technology – These two go hand-in-hand. Whether you market with trade shows, direct mail, email, web-based marketing, or any combination, make sure that your company’s technology keeps pace with your growth. While technology now allows you to reach and gain many more customers, your customers will have special handling requests, they will need management reports, and
they will want quick answers. Your ability to utilize systems and technology allows your business to innovate, remain flexible to increased customer needs, while your business expands with new business created by your efforts in marketing.

Work Hard — Most of your business success is tied to your personal work ethic, and your business’ related culture. Put the idea of being entitled to anything out of the equation – be prepared to work for everything, and you may find that the harder you work, the more opportunity comes your way.

Persevere! — Push through the tough times, and keep emotions in check. When you are attached to your business’ success or failure, things can seem very personal. They’re not – it’s business. Read your emails twice before you respond to a complaint, and if a problem or issue seems too complex at the time, sleep on it – handle it in the morning. And ask advice from someone who has “seen the play” before.

View the Comp Marketers Blog here: http://christinachilders.blogspot.com/2011/11/compmarketer-newsletter-november-2011.html

 

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Posted in California Work Comp Professional Development
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How are recent claim trends impacting you?

Published by admin on October 29th, 2011

For the last 25 years inflation for medical care has been surging ahead of general inflation (CPI), causing the medical care component of workers compensation claim costs to rise, according to the Department of Labor. In addition, the Insurance Information Institute reports that if trends hold, the medical costs associated with workers compensation claims are projected to equal 70% of total claim costs by 2017, compared to 46% in 1987, 53% in 1997, and 59% in 2007.*

Unemployment rates continue to be high across nearly all major private-sector industries. With this unemployment, many employers no longer have the luxury of accommodating injured workers in light duty positions, according to a November 15, 2010 article in National Underwriter PC Magazine, by Robert Standen. These trends may result in escalating work comp costs as full weekly benefits are paid for longer periods. Most claims professionals find that the longer a claim remains open, the more expensive it becomes.*

Drug costs are escalating due to the rise in their average wholesale price. According to a 2008 NCCI report, prescription drugs typically account for approximately 3% of total claim costs in the first year, increasing to 15% of total claim costs after four years, and over 35% of total claim costs after a seven-year lifespan of the claim.*

If you’re experiencing escalating work comp claims costs and longer file closure times, Resolution-Partners can help with a full suite of lien resolution, litigation and bill review services.

* Source: National Underwriter PC Magazine, November 15, 2010, by Robert Standen

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Posted in California Workers Compensation Cost Control, California Workers’ Compensation Trends

Medicare Conditional Payment Liens Create More Work for Adjusters

Published by admin on August 9th, 2011

With the advent of MMSEA, insurance companies, TPAs and employers are required to advise Medicare of all claimants who are current Medicare beneficiaries. The Centers of Medicare and Medicaid Services (CMS) cross-match this information against medical bills paid by Medicare, and send out a notice of lien for Medicare Conditional Payments issued on behalf of the claimant. If any Conditional Payments are identified, even if treatment is unrelated to the workers’ compensation case, CMS demands reimbursement. It’s up to the claims administrator to dispute or pay the lien. To further complicate matters, disputes involving CMS fall under the jurisdiction of the federal courts – not the CA Workers’ Compensation Appeals Board. Be ready for this potential massive exposure.  If you’re ever in doubt, contact RPM for CMS lien expertise.

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Posted in California Lien Resolution, Medicare Conditional Payment Liens

Recent Lien Developments

Published by admin on July 27th, 2011

Recently, there have been many new developments affecting lien management; including changes to the DME fee schedule, compound drug legislation and some progress of various other Bills in the California Assembly or Senate.  Below are a few details. We’ll keep you informed as these changes continue to roll out.

  • The Division of Workers’ Compensation (DWC) posted an order adjusting the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) section of the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1. For more information, visit http://www.dwc.ca.gov.
  • In February, SB 457 was introduced which would authorize liens in excess of the OMFS in cases where a private health care provider treats an injury that is later determined to be compensable under workers’ compensation. Many are concerned that the bill’s wording could open the door for excessive treatment. A hearing is scheduled on 8/17/11.
  • In June, the California State Assembly passed the Compound Drug Bill. The Bill caps reimbursement rates and calls on the DWC to adopt a fee schedule for compound medications. A hearing is scheduled on 8/15/11.
  • Provider fraud cases are exploding (contact RPM for specifics), and…
  • SB 862 would require liens be filed in writing and create filing deadlines, a hearing is scheduled on 8/17/11.

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Posted in California Lien Resolution, California Work Comp Reform, California Workers’ Compensation Trends