How Retro Rating Can Help You

  • External access
    Access to claim & employer account information for retro participants.
  • Reports
    Monthly & quarterly reports on account status and claim activity.
  • Claim management
    Financial incentive coordinators consult with employers on workers' comp claims.

External access

Access to claim & employer account information for retro participants.

For the purpose of ensuring confidentiality of information being transmitted via the Internet, a new registration process has been established. This new process requires digital certification prior to using the on-line Claim & Account Center .

For Retrospective Rating customers, there are approximately 30 screens of both claim and employer information available. These screens include information on claim activity, such as claim status, payments, and case reserve information. It also provides access to employer information including policy information, risk classification and rates, and premium payment information.

The service is available to all Retrospective Rating groups/associations, fake groups, and/or individual enrollees. It is also available to third party representatives for Retrospective Rating customers. Individual employer members of a Retrospective Rating group/association are able to register for a separate, limited access to their own account/claim information.

Reports

Monthly and quarterly reports on account status and claim activity.

On a monthly and quarterly basis, Retrospective Rating customers receive a comprehensive report on the status of their account/claim activity. This report includes a Composite Claim Report, Summary of Claim Costs, Claim Analysis by Type of Accident, and Claim Analysis by Nature of Injury and Body Location.

Historically, Retrospective Rating monthly and quarterly reports have been produced on paper and mailed to customers. In an attempt to reduce paper, mailing costs, and preparation time, we have developed electronic access to the Retrospective Rating report information, including download capability, via a secure Internet connection.

Claim management

Retro financial incentive coordinators consult with employers on workers' comp claims.

Claim management and return to work programs must be built on a solid foundation of management commitment and support. A written policy and procedures manual must be communicated and understood by all employees and all levels of management. Retro financial incentive coordinators can provide assistance to employers who are interested in learning how to prevent injuries from occurring and/or managing their claims if they do occur.

The basic procedures for good claim management include:

  • Develop a claim management and return to work program policy and procedures manual and obtain approval and support from top management.
  • Develop accident reporting procedures.
  • Establish a system for monitoring claims.
  • Establish a return-to-work (RTW) program.
  • Designate a company representative to serve as a claim management coordinator.

Typical duties of the claim management coordinator include:

  • Communication — The claim management coordinator can be the point of contact for all telephone and written communication concerning workers' compensation claims.
  • File/record keeping — The claim management coordinator can be responsible for maintaining all correspondence relative to the employer's record of the claim.
  • Tracking and monitoring — The claim management coordinator might initiate and/or respond to all communications and correspondence concerning claims as quickly as possible to ensure that issues are resolved in a timely manner.
  • Resource — The claim management coordinator must be knowledgeable on how to get additional help or information to ensure effective claim management.
  • Monitoring the medical treatment progress — The law requires that physicians attending to the injured employee must comply with the rules and regulations on submitting medical reports to L&I (see RCW 51.36.060 (www.leg.wa.gov) and WAC 296-20-06101 (www.leg.wa.gov)). To ensure that reporting requirements are being followed, the claim management coordinator must review the file to monitor claim activities.

Another effective claim management tool is contact with the attending physician. The employer has a legal right and responsibility to contact the attending physician to discuss matters concerning their injured employee's claim and return to work issues. Questions to ask the physician include:

  • What is the diagnosis? What's wrong?
  • What is the prognosis?
  • What are your plans for treatment?
  • When can the employee return to work?
  • Would you consider releasing the employee to modified or light duty?
  • What can we do to assist the employee in returning to work?

It is also recommended that contact be made with the injured employee on a regular basis to provide assistance and encouragement with regard to his/her injury and progress for returning to work.

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