Claims Management


Workers' compensation costs go up by accident... but they certainly do not come down by accident. Managing a workers' compensation claim is a serious undertaking in which errors and missteps can be extremely costly. The manner in which an individual claim is managed determines not only its own direct cost, but also its financial impact on premiums in subsequent years.

At Stephenson+Brook, claim consultants have an average of ten years of professional experience. They bring this experience, as well as interpersonal skill and interdisciplinary expertise, to the benefit of every client and every claim. 
 

  • Review all existing open claims. Design and execute a strategy for closure with optimal cost-saving impact.
  • Manage individual lost time claims, when beneficial, evaluate and price cost-effective lump-sum settlements.
  • Conduct an independent medical review and work with attending physicians to establish timely and realistic medical and lost time assessments.
  • Work with client's staff and legal counsel to prepare for proceedings. 
  • Audit, assess and negotiate favorable reserves.
  • Handle reporting and statistical analysis, including unit statistical review with the insurance carrier.

Premium Recovery


A workers' compensation premium involves complex and highly technical cost-driving details. Credits, modification factors, employee classifications and endorsements all contribute to the final premium calculation. 

Stephenson+Brook's Premium Recovery Service is strictly a contingency-based service. Our actuaries review and analyze the workers' compensation policy to ensure the accuracy of the cost-driving elements. If mistakes are discovered and past premium overcharges are recovered, Stephenson+Brook is paid a percentage of the recovered costs. If the audit results indicate that there are no mistakes, our service is entirely complimentary.
 

Wrap Up Reconciliation

Stephenson + Brook’s Wrap Up Reconciliation Service involves the auditing of all pertinent wrap up payroll that should have been included within the appropriate time frame(s) of the relevant Experience Mod Rating (EMR).  We confirm that all claims reported are consistent with the policy periods of the wrap up projects. If there is additional payroll to be included, or incurred claim amounts to be adjusted, we will calculate the impact of these changes to the EMR, and discuss with the client in order to determine the best way to proceed. 

First Reporting Service

 

Stephenson + Brook specializes in identifying workers’ compensation needs of businesses across multiple industries and State jurisdictions. Our First Reporting professionals are trained to recognize unique obstacles that employers face and help make the process of reporting workers’ compensation claims as seamless as possible. We offer 3 simple reporting methods; claim submission by phone, fax, or email while adhering to the specific statutory requirements when reporting claims to the insurance carriers, third party administrators and State industrial accident departments.  Once notified of an injury, Stephenson + Brook immediately contacts the employer’s onsite supervisor to discuss the accident details and injury treatment options. Our in-house nursing staff is also available to answer any medical questions and to work with the employee’s medical provider to ensure timely treatment. Once the reporting process is completed, Stephenson + Brook continuously works with the insurance carrier’s claims adjuster to ensure that the claim is efficiently managed and monitors the claim for lost-time status. Our First Reporting staff will also offer training on proper handling of work related injuries, implementing modified duty plans and identifying loss trends as needed.

Medical Cost Containment


At Stephenson+Brook, we have the tools, the know-how and the experience necessary to control the costs associated with the medical care of injured employees. Our staff nurses track workers' compensation patient care to ensure that medical services are neither over-utilized nor under-utilized. Our service is stream-lined, efficient and effective. 

Our approach to medical cost containment is fully coordinated and multi-dimensional. Depending on the expressed needs and requirements of our clients, we offer the disciplines of medical and surgical fee negotiation, medical bill review, pharmaceutical review, nurse case management, bill auditing and utilization review. 

Our proprietary medical and pharmaceutical bill auditing makes certain that the workers' compensation medical bills correspond precisely to established diagnosis, treatment and procedures. We ensure coding accuracy, state reimbursement compliance, non-duplication of payment, and we verify that the services rendered are related only to the specific industrial accident at issue. 

We deliver dramatic cost savings, typically between 25% and 30% in charges when we negotiate medical and surgical fees. We apply the guidelines of our client, as well as the published guidelines of the American Medical Association in medical coding to contribute to savings for our clients.

Stephenson+Brook is proud to have worked with insurance industry leaders such as AIU and Public Service, and with clients such as Harvard University, Boston's Central Artery Tunnel Project, Fenway Park, Children's Hospital, Brown University, City of Boston, Boston Fire & Police, City of Waltham and many more municipalities. 
 

State-Approved Credit Programs

 

Increasingly, states all across the country are introducing ways to encourage companies to take advantage of lowering workers' compensation costs. In Massachusetts, this incentive program is called the Qualified Loss Management Program (QLMP) and in New Hampshire, it's known as the Safety Incentive Program (SIP). The QLMP in Massachusetts offers four years of premium credit discounts and the New Hampshire SIP offers three years of premium credit discounts to companies in the Assigned Risk Pool who work with Stephenson+Brook. 

In Massachusetts, the Workers' Compensation Rating Bureau has awarded Stephenson+Brook a QLMP rating of 15% for 2017. Companies in the assigned risk pool in Massachusetts who retain Stephenson & Brook to help control their workers' compensation cost through its LOSSGUARD Program, will receive a premium discount credit of 15% in year one, followed by declining discounts in the following three years.

In New Hampshire, Stephenson+Brook is certified by the National Council on Compensation Insurance (NCCI) to provide LOSSGUARD to companies in the assigned risk pool. When employers work with Stephenson+Brook, they receive the maximum premium credit of 10% in year one, 7% and 3% the following two years.

LOSSGUARD educates and trains the employers in Stephenson+Brook's proven loss control techniques. The goal is to minimize workplace hazards, increase safety awareness and reduce accidents and injuries. In addition, its state-of-the-art claims management strategies are introduced to reduce losses and lost days through effective post-injury response, measured rehabilitation and safe return-to-work programs.

Safety Services

 

  • Accident Prevention Training
  • Safety First - an Employee Communications Program
  • Risk Management Audit
  • Hazard Communication 
  • Safety Communication Program
  • Hearing Conservation Program
  • Emergency Procedures
  • Confined Spaces
  • Lockout/Tagout
  • Material Handling
  • Self Inspection Program
  • First Responder Program
  • Housekeeping Training
  • Slips & Falls
  • Fire Protection
  • Lifting & Bending - Lower Back Pain
  • Blood Borne Pathogen
  • Hand Washing/Virus Protection
  • Skin Protection
  • MERSA Protection
  • OSHA Problem Solver 
  • On-line access to loss and statistical information
  • Wellness Programs 
  • Ergonomics
  • Substance Abuse
  • Motor Vehicle Safety
  • Safe Job Placement for Temporary Workers
  • Stress & Anxiety
  • Depression