Tips for Teamwork

Have you ever been frustrated by disability approvals or reimbursement of indemnity benefits to your agency that are issued based on inaccurate information?  Have you ever spoken with a Benefit Coordinator and realized that they don't have the information that you have?  It takes real teamwork between the Agencies, Benefit coordinators, and the VSDP Coordinator – the Disability ABCs - to ensure that information flows quickly to facilitate timely and accurate approvals on a claim.
 
MCI Benefit Coordinators are not only responsible for timely and accurate payment of workers' compensation benefits, but for those employees receiving occupational VSDP benefits, they are also responsible for providing disability approval to Reed so that Reed can issue Action reports.  In fact, our program's VSDP Coordinator is dedicated to facilitating the complicated flow of information between WCS and VRS. 
 
What can you do to help the process?  Develop processes within your organization to  assure that all disability slips, workers' compensation leave slips, medical notes, internal investigative notes and the like are promptly provided to you.  Then, the faster you can get the information to us, the faster and more accurate service we can provide to you, to the injured worker and to the VSDP program resulting in timely reimbursement to your agency, timely and accurate updates from MCI to Reed for action reports, fewer telephone calls to you and less confusion for your injured workers!

This Tip for Teamwork has to do with timely reporting of claims.  Everything in the claim handling process flows from the First Report of Injury (FROI).  The Governor’s Executive Order 109 (10) requires claims to be reported to WCS within 10 days.  This is not only because the Virginia Workers' Compensation Act requires us to report claims to the Commission within 10 days, but also because the earlier we can begin to work on your claims, the better job we can do in making prompt compensability decisions, getting your employees the medical treatment they need, and involving our field nurses and vocational consultants quickly to facilitate early, safe return to work.  You can check your "lag time" statistics by running your "Workers' Compensation Lag Time Report" in Visual Report Studio on demand, or check your VRS inbox for the push report delivered during the first week of each month for the previous month.

This Tip has to do with information.  Remember the old computing acronym "GIGO"?  It stood for "Garbage In – Garbage Out" and meant that the data extracted was only as good as the data inputted.  Each claim for workers' compensation begins with information shared by the employee concerning a workplace injury or illness.  As you collect the details of the incident and other information, it would help us provide faster compensation decisions if you could double check for up-to-date addresses and phone numbers as well. The information that you provide to us via Visual Liquid Web is critical to the Benefit Coordinator to start the claims administration and investigation process.  It will save a lot of time in the long run and prevent an additional call to you seeking accurate information when your claims team is having trouble reaching your employee.  If your employee has multiple claims with our office, all claims will be automatically updated with the current contact information when the new claim comes in! 

You may have recently seen a number of notices from the Virginia Workers' Compensation Commission on old claims with dates of injury before October 2008.  Have you wondered why?  So did we!  We investigated with the VWC and wanted to pass on what we found.

 

Beginning in October 2008, the VWC required that all new claims and all their related "transactions" such as name and address changes, new agreements and so on be filed electronically.  All older claims transactions continued to be filed in paper.  Now the VWC is ready to move those legacy paper claims into the electronic or EDI process.  All carriers and self-insurers are required to comply by July 5, 2012, but we are currently in the voluntary compliance period.  MCI recently filed a large EDI submission of legacy claims dating back to the mid-1980’s. 

 

According to the VWC, an anomaly occurred within their EDI system which triggered the generation of multiple notices on these older claims where any current information does not match the information in the VWC’s paper files (remember that some of these claims were filed over two decades ago).  This has caused a very large influx of notices to both our claims unit and agencies.  We understand the problem affected other carriers, self-insurers and employers as well.  Once the problem was identified, the VWC temporarily turned off their notification generator to allow the completion of the EDI submission process on these legacy claims.   MCI will address any needed changes from the notices already received through the EDI process and there should not be any action needed from you on most of these pre-October 2008 claim notices.