About This Course:
Recent estimates state that fraudulent or exaggerated workers' compensation claims account for a whopping 25% of the total money spent on workers' compensation!
So...are you sure that workers' comp fraud is not happening to your organization?
Knowing the common signs of a fraudulent claim can make the difference between a denied claim and an unnecessary six figure settlement, and though we want to be trustful, fraud and misrepresentation become more prevalent everyday - and knowing what to look for is your best defense.
Sometimes the tell-tale signs of a fraudulent claim are apparent right away; other times they don't develop until the claim is already in progress, but either way, you need to know what to do to protect your organization.
What You'll Learn:This training session will help you learn:
- The red flags of what could be fraudulent behavior
- What to do when you suspect someone is committing fraud or a misrepresentation
- What rules - including HIPAA - inhibit your ability to address fraud
- When I can deny a claim based upon fraud
- When I can criminally prosecute someone for committing a fraud or misrepresentation
Top FAQs
Insurance Agents also should understand his or her applicable state's workers' comp rules and requirements, responsibilities of the organization, proper procedures for claims handling and return-to-work, and how to investigate claims of fraud.
oss costs, loss cost multipliers, rates, experience modification factors, schedule credits, premium discounts, expense constant. Unravel the mystery and learn why some employers pay much more than others for the same coverage.
Workers Comp is an insurance that provides certain wage and other benefits to people who are injured or become ill at work. Coverage and benefits are mandated by each individual state and can vary according to the state in question.
What you need to track, when you need to track it, and why
Prompt reporting, quick action, managing care, and a return-to-work planning.
Develop, maintain, and manage the organization's workers' comp program, including communicating with employees, managers, insurance carriers, medical providers, attorneys, and upper management, handling claims, the reporting requirements, medical-related issues, and fraud investigations.
Continuing Education Credits:
Click the 'Credits' tab above for information on PHR/SPHR, PDCs, and other CE credits offered by taking this course.
