The following list offers a brief description of some additional consulting services we are available to assist you with:
1. Excess insurance reporting:
Claims which have paid statutory values in excess of the self-insurance retention level are eligible for reimbursement from the excess insurance carrier. Each policy contains specific reporting requirements which must be met in order to qualify the claim for reimbursement from the policy.
Reports for reimbursement from the excess insurance policy must not include amounts recovered from other sources and, therefore, paid values must not be extracted from the claims administration systems without modification. Typically the types of claims which qualify for this reimbursement are also eligible for reimbursement from the Retroactive Program, thus, it is a natural "fit" for ComPro, Inc. to prepare an excess insurance report on a regular schedule concurrent with our Retroactive Program reimbursement report.
The Quarterly cost for this service is $60.00.
2. Compliance audit assistance:
Undergoing a State of Oregon Compliance Audit can be an extremely invasive and stressful experience. It often causes significant negative impact on a claims processing office's relationship with upper management and/or with their clients in the case of a third party administrator.
ComPro, Inc. is uniquely trained to facilitate you through this painful process by actual on-site intervention directly with the auditors or by an invisible response to audit referrals in your behalf. Auditors often make deviations and findings which are based on incomplete information. A review of audit samplings and worksheets may result in positive changes in the audit findings, as well as offering an opportunity to develop staff training programs designed to prevent future problems in any given category.
Following the audit, we can assist you in preparing the client for the report which will follow, and help them to understand the WCD focus and your plan of action to correct critical findings of the audit.
This process is billed at our hourly consulting rate of $75.00 per hour.
3. Self-Insurance program setup:
ComPro, Inc. staff have assisted in the setup of several self-administration self-insurance programs. Our knowledge takes the guesswork out of a very complex, exciting and profitable experience. We can walk you through from the beginning of the process to the end of your first year and assure your program is successful.
The fee for this service is agreed upon in advance and is predicated upon the level of service desired.
4. Individual claim audits (benefits due versus paid)
Insurers often utilize our services to audit benefits due on claims in order to allow deduction of overpayments from permanent disability awards or perhaps to prepare the file for settlement purposes or compliance audit. Our assistance becomes useful when a claim is going to hearing relative to correct payment of benefits. Our audits have a favorable reputation and are known to withstand legal review.
In order to complete a correct audit, wage records which conform to the Division 060 rules are required for pre-injury and post-injury periods. The worker's average weekly wage is recalculated to verify accuracy. Compensation rates are determined for all periods due, then using these components, the correct amount due a worker is determined. The waiting period is applied based upon the facts of the file. The claim record is then reviewed to determine correct amounts paid. Benefits due versus paid values are compared to establish an overpayment or underpayment. A worksheet showing all calculations is provided along with TPD worksheets when applicable.
A ComPro audit is normally well received by both defense and claimant's attorneys and is a document welcomed by Compliance Section when they come to audit your file.
Our usual fee for this service is $50.00 per claim volume. This means if you have a claim which has 4 brown bags it may cost you $200.00 to $500.00 to complete the audit if it encompasses the life of the claim. If the audit is for a limited period of the claim such as an aggravation period, the audit will most likely cost $50.00. If the audit is for legal support purposes it may cost significantly more as the documentation must be very detailed. Fees can be discussed at the time of the audit so there are no surprises.
We will often be called upon to provide the examiner with a calculation of the worker's base wage and compensation rate which is then a good basis for ongoing benefit determination throughout the life of the claim.
5. Worker Benefit Fund claim audits:
Because of the complexity of benefits due on claims which qualify for reimbursement from any of the Worker Benefit Fund Programs, ComPro, Inc. is often called upon to review the entire claim payment records to assure all reimbursable benefits are recovered from all possible sources. This is often a very profitable audit process and does require an extensive knowledge of historical laws, rules and bulletins, something ComPro, Inc. staff are uniquely skilled in.
6. Temporary claims examiner assistance:
We really like to be available to help you through staff shortages, vacations and stress times. Doris has even at times been found in the file-room organizing and clearing up a backlog of mail for friendly clients. Fees for this type of work are negotiable and are typically in line with other companies who provide this type of service.
8. New staff training:
ComPro, Inc. staff are available to sit with your new staff person and help them learn your procedures and basic job duties. This type of training is most effective when we have an ongoing working relationship with your company so that we are familiar with your computer and how you want various job functions to work within your team environment.
Basically if the job has to do with Oregon Worker's Compensation and you have a need, we are open to discussion about filling that need.
Please keep us in mind should the need arise for assistance in any of the above services. You may call us at 503-485-2344 or e-mail: email@example.com to discuss details.
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