TASB Risk Management Fund
INSIDERM

Fund WC Program on Top Again

December 01, 2016 Krista Fergason

Workers' Comp

doctor types on computerMembers save time and money

We are proud of our efforts to keep costs down for members filing workers’ compensation claims and to process claims in a timely manner. Recently, the Texas Department of Insurance released two separate reports that acknowledge the Fund’s efforts to provide efficient service that also keeps costs under control.

TDI Report card

The 2016 TDI Network Report card, which evaluates the effectiveness of medical care that workers’ compensation claimants receive, was released September 30, 2016. This evaluation reviews medical costs, utilization measures, return-to-work, and satisfaction with medical care received.

The Fund, along with four other risk pools, is a member of the Political Subdivision Workers’ Compensation Alliance (Alliance), an interlocal entity created in 2007 to provide a way for the pools to jointly contract with medical providers for care.

The Alliance is the second largest of the 17 networks in the state measured on the report card with almost 23,000 claims in the data set this year.

Since the 2009 report card, the Alliance has performed well. Throughout those years, overall medical costs have stayed virtually flat with only a 3 percent increase for the entire period. This is outstanding considering the CMS (Medicare) fee schedule has increased more than that.

High performance tier

In November 2016, The TDI Division of Workers’ Compensation released results of the 2016 Performance Based Oversight assessment. The TASB Risk Management Fund was recognized as a High Performer with an overall score of 98.96 percent out of 100 percent. To receive this designation, a Workers’ Compensation carrier must meet or exceed 95 percent compliance with TDI requirements for accuracy and timeliness in claims handling.

Performance was based on timeliness of the following:

  • Payment of initial Temporary Income Benefits;
  • Processing of initial medical bills;
  • Processing of request for reconsideration medical bills;
  • Submission of Initial Payment data via Electronic Data Interchange; and
  • Submission of Medical Bill Processing data via EDI.

Tagged: "Network Report Card"