Question

1) When a patient makes an appointment for an injury that could have occurred on the job, the scheduled asks whether the visit is work related. If the answer is yes, what other information should the insurance specialist collect? Please communicate your thoughts in complete sentences with appropriate grammar, punctuation and spelling.

2) Determination is a part of the claims adjudication process. What are the three outcomes or determinations that are made for a claim?

3) Explain what an aging report is and how an insurance specialist would use it?

Answer 1

1, Insurance specialist collects information about a written notice about the return to work and worker comp benefits and approved doctor for an independent health examination.
2,  -once the claim is approved the insurance specialist will the employee for payment detail for payment offer that include the medical bill, disability payment, part of last wages
- Obtain large sum settlement
- improve their return to work can be considered.
3, Injured worker insurance claim process involves in a workers' compensation claim, enhance worker experience procedure to improve their return to work. The aging report is to investigate the severity of injury at work as per age groups. it helps insurance specialist to calculate the claim benefits for the employee. Workers aged 56 and above have a 33% higher rate of reporting for positive claims than younger workers.