FIRST REPORT

These services are performed as a joint venture with Advocase

Early intervention is the key to providing optimal outcomes, particularly in workers’ compensation, commercial, auto related or general liability cases. Prompt notification and initiation of medical management helps assure that injured persons receive appropriate treatment, expedites their recovery and return to work, and may reduce litigation.

First Report of Injury is a fast and easy service that greatly simplifies the reporting process for workplace and auto related injuries, as well as non-occupational disability, property and general liability claims. Compmed ’s First Report of Injury Service promotes immediate intervention after such occurrences. Our First report of injury can be accessed telephonically. We can transmit the First Report of Injury to a designated representative within four hours of notification.

For clients intrested in a more detailed discription of the first report process please see below:

Objective:

To offer CMA Partnership clients and prospects with a call center solution that lowers claim costs and exceeds expectations by providing:

Accurate injury reports
Exceptional customer service
Advanced technology interfaces

Target Audience:

CMA Partnership clients and prospects that utilize other vendors (versus in-house programs).
Large Workers’ Compensation and Group Health insurance carriers, and self-funded employers.
CMA Partnership clients and prospects that have an in-house program that require after-hours, holidays and weekend support.
CMA Partnership clients who want the advantage of the First Report system within their own call center along with backup, overflow and after-hours, holidays and weekend support from CMA Partnership’s call center.

Targeted Line of Business: Workers’ Compensation, Auto, Long Term Disability (LTD)/Short Term Disability (STD), Property and General Liability.

Program Overview:

Early intervention is the key to providing optimal outcomes, particularly in workers’ compensation, commercial, auto-related, or general liability cases. Prompt notification and initiation of medical management helps assure that injured persons receive appropriate treatment, expedites their recovery and return to work, and may reduce litigation.

First Report is a fast and easy-to-use service that greatly simplifies the reporting process for workplace and auto-related injuries, as well as non-occupational disability, property and general liability claims. CMA Partnership’s 24-hour First Report service promotes immediate intervention after such occurrences. Our First Report service can be accessed telephonically or via System Lease. The system can transmit the First Report to a designated representative within 4 hours of notification.

How it Works

Call Record: An injury, incident or loss occurs. The designated representative contacts the 24-hour First Report service via phone or accesses the application through System Lease. The average length a caller has to wait for a representative is less than 30 seconds. When a call is placed, the experienced representative prompts the caller through the appropriate questions required by the state and employer. First Report can work with the employer to set-up a customized script.

System Lease: An injury, incident or loss occurs. CMA Partnership will assist the client in implementing the First Report application in a browser-based environment, accessible with Internet connectivity in the client’s own location. CMA Partnership will continue to administrate client policy setup information and claim distribution.

Report Generation: CMA Partnership will generate a first report on state-specific forms via fax, Internet Email, express delivery, and/or U.S. Mail to the employer, insurance carrier, TPA, case manager, agent and other appropriate parties.

Data Transmission: First Report can electronically transmit claim information to clients’ claims systems for their initial claim set-up, minimizing client data entry. First report of injury information can be directly sent to the appropriate parties through e-mail. Email distribution will require a fully executed Hold Harmless agreement.
First Report Impact

Increased claim control with a one-step solution for reporting injuries.
Decrease in claim costs through early intervention and efficient reporting of injuries.
Reduction in litigation and litigation costs through prompt and courteous interaction with injured party.
Increased efficiencies through electronic transfer of injury information directly into clients’ claims systems.
Ability to control catastrophic claim costs by initiating client specific catastrophic protocols, including an escalation of CAT claims through immediate notification to the adjuster.

Pricing:

First Report is priced on a per claim basis. The price is determined based on volume of claims, distribution set-up, and volume of employer locations received via standard inbound EDI. Claim pricing varies depending upon intake method (Telephonic or System Lease).
For System Lease, there is a minimum annual requirement of 100,000 claims. System Lease pricing also includes one week of on-site training.
Three distribution points are included with the per claim price, additional distribution points are charged an extra fee per transmission.
Implementation fees are based on the volume of the initial set up of employer locations and any requests for customization.
Inquiry calls that exceed twenty percent (20%) of total claim volume may be subject to additional fees per call.

Reports:

The following reports are available to clients:

Monthly Volume Reports
Monthly Injury reports (both detail and summary)
Monthly Management reports: including call time of the reports and lag time of when the injury occurred versus when it was reported
Monthly Report Card (call center statistics)

Customized and ad-hoc reports are available at an additional charge