Medicusrx claims management Services

 Following our open and honest communication philosophy, we establish from the beginning of the claim an atmosphere of mutual dignity and respect. Ensuring the injured worker knows their rights and responsibilities. Their claims will be managed promptly, administered fairly, and they will receive the full measure of benefits to which they are entitled. MedicusRx feels effective communication is proactive in claims management to avoid misunderstanding and frustration to minimize litigation. Establishing and maintaining consistent initial and ongoing communication is a priority. The MedicusRx examiner will contact the injured employee at a minimum every 14 days after initial contact and all missed calls will be returned within one business day.

MedicusRx’s claims capabilities includes management of commercial auto and general liability claims for corporations and public sector entities. We manage your simple slip-and-fall incidents to serious injuries and fatalities; our priority is to provide effective resolution of claims. At initiation of the claim, we start with a thorough investigation of all issues involved before deciding on the most appropriate approach and resources required. Our focus is good faith resolution by means of the most cost-effective solution. By utilizing the full range of support services offered by MedicusRx, we utilize the necessary resources to achieve the best most efficient results. We can handle any liability claim, regardless of complexity, from start to finish, which may result in faster claim closure rates, reduced litigation and lower total cost.

MedicusRx's Claim Management System, ClaimPilot is web-based and can be accessed with any web-enabled device with an internet connection. Each user is provided a unique username and password that adhere to standard unique naming conventions. ClaimPilot provides its users the ability to enter detailed claim information with standard and custom fields. This provides a convenient, efficient way for our customers to report claims 24 hours a day, seven days a week. Our staff is trained to manage all lines of coverage, which may be reported using one of the following:

• Phone: MedicusRx claim line remains available 24/7 for emergencies.
• Fax/email: Fax and email are available for standard reporting protocols
• Internet: This online application features screens that can be customized and are available for both external and internal reporting
• EDI: This allows our customer to submit claims through a standard electronic file

Reserves are to be set based on the estimated probable cost of the claim. 

An initial reserve is to be setup within one (3) business day of receipt of the assignment for workers’ compensation claim. The claims examiner and supervisor will address the adequacy of the loss and expense reserves at each diary date.  The claims examiner may contact client's designated representative for significant reserve adjustments as they occur or approval for significant changes by client’s designated representative.

To implement cost-containment measures and create uniformity, mitigate damages, and improve

outcomes for litigated matters MedicusRx adopted and implemented the AIG Litigation Management Guidelines. MedicusRx claim examiners will arrange legal representation for all legal proceedings, with mutually agreed upon defense counsel. Our claim examiners can attend any legal proceeding as needed. MedicusRx has an extensive history in handling litigated matters  with several defense firms and attorneys, nationwide.

  Our in-house physicians have worked with more than 90 law firms over the years including Contested Case Hearings, Depositions and Live Trials. We assist defense counsels with detail medical information prior to hearings, depositions, and live trials.

Identification and investigation of potential subrogation or second injury fund maximizes recovery potential and reduces client / carrier loss cost. All claims with potential subrogation are managed by our claim examiners, who works with our subrogation attorney to evaluate and pursue recovery opportunities. MedicusRx’s in-house physicians will be available for any needed assistance or clarification.

  The claims examiner will contact the client's designated representative to discuss subrogation pursuit. Subrogation status is addressed by the examiner in every action plan. Meetings and updates are scheduled at the client's request or as file status warrants. The client will be notified of the final disposition of all subrogation matters. 

MedicusRx utilizes a completely web-based Claims Management System that combines the ability to gain overall knowledge and immediate insight into your claim program with a rich library of risk management tools. You can view the different dimensions of your claims. You can select, display, print and distribute financial and loss reports important to proactively managing your cost of risk. 

• More than 100 (one hundred) standard report templates convey a vast amount of intelligence in easily understandable formats 
• Reports allow you to view the value of your database as of any historical point in time, enabling accurate period-to-period comparisons 
• Ad hoc reporting creates custom analytics to individualized specifications 

A Return to Work/Transitional Duty Program allows injured workers to progressively build up tolerance for work activities in a controlled, supervised fashion, while performing productive work.  Our claims team has experience in establishing return to work programs and can assist with the development and implementation of a safe, successful program for your organization.