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Doctors Affect RTW And Your Bottom Line

Doctors Affect RTW And Your Bottom Line. Norm Peterson, President, NPA Associates Jim Libien , Esq., Laughlin, Falbo , Levy, & Moresi Jack Blyskal, CPCU, ARM, CSAC EIA. Working Hypothesis.

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Doctors Affect RTW And Your Bottom Line

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  1. Doctors Affect RTW And Your Bottom Line Norm Peterson, President, NPA Associates Jim Libien, Esq., Laughlin, Falbo, Levy, & Moresi Jack Blyskal, CPCU, ARM, CSAC EIA

  2. Working Hypothesis • Certain doctors treating 4850-eligible patients did not provide information to facilitate early RTW, including work restrictions. • City of Oakland example • Two physicians, firefighters only, cost the City $1.4M in 4850 costs

  3. Formed Committee • Committee Makeup • RTW provider • TPA provider • Excess pool manager • Legal counsel • JPA Members • Risk Managers for Public Entities, including City of Oakland

  4. Ideas Considered • Root causes • Doctors affiliated with unions • Doctors not specializing in Occ Med • Patients eligible for 4850 benefits • Possible approaches • Legislation • Get doctor association to oversee • Approach DIR for oversight

  5. Data Analysis • (See handout) • 4850 was NOT the driver of extended disability • Difference lay between the Occ. Med doctors and Non-Occ. Med doctors • Cost impacts were found as high as 8-9 times for Non-Occ. doctors

  6. Solutions Considered • Legislation • Time consuming, complicated, difficult with Senate/Assembly makeup • Regulatory • Met with Director of DIR • Inability to enforce requirements • Informal • Met with doctor association

  7. Solutions Considered • Administrative • Implement report specifically addressing work limitations • Allow $25 fee for form completion • Implement on trial basis with three identified customers • Results

  8. Other Ideas • Open Forum • What do you think?????

  9. Questions?

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