I’m a geek. I like numbers, models, and the big picture. Like a moth to a flame, I find big data both enticing and terrifying. When it comes to outlining clinical best practices, I want to understand the available evidence. But really, why would a disability and workers compensation medical director care about predictive modeling? […]
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December 2016 – STD Claims
As I go around the industry, meeting many talented and experienced people who are involved in managing disability claims operations discussing the introduction of claim segmentation, the biggest issue is the ‘change’ in the process. How to do this without causing an issue? The rational for claim segmentation is clear, as soon as we suspect that an STD […]
November 2016 – The Cognitive Kitchen
The Mental Health Cognitive Kitchen – Recipes for a better understanding of Mental Health conditions. The Ingredients of the Diagnosis How do we determine if someone has a medical condition? We use tests such as MRIs and X-rays. From those tests medical conditions can be discerned and then treated appropriately. With a mental health condition there […]
October 2016 – Life in the ‘Fast Lane’
Does your claims process have a fast lane? Claim segmentation is a vital part of a more effective STD process, with less complex claims put through a ‘Fast Lane’ leaving claim managers more time to spend on complex claims. We have a fast lane for highways, Disney World, people with 10 items or fewer at […]
Let’s Go Back To Work
The Claim Lab is developing specialized models to predict return to work (RTW) for a range of conditions. Whilst doing our research we’ve referenced some previous studies, one we found particularly interesting was published in Neuropsychiatric Disease and Treatment, ‘Let’s get back to work: survival analysis on the return-to-work after depression’.[1] Aim The aim of this […]
August 2016 – Auto Adjudication
There is a big opportunity in many claims operations to improve efficiency with greater automation of claims decisions. Every STD claim is still most likely touched by a claim manager, this isn’t an efficient approach, and there is a better way! Let’s ask some basic questions: What proportion of your STD claims are maternity claims? […]
July 2016 – Keep Your Eye on the Goal
Work-Focused Psychotherapy Helps Employees Return To Work Sooner Research published online in APA’s Journal of Occupational Health Psychology has found that employees who received work-focused therapy, returned to work sooner, did not suffer adverse effects and showed significant improvement in mental health over the course of one year. It turns out that maintaining a strong […]
June 2016 – Dutch Mental Health Study
As you are likely aware the Claim Lab is refining its models that predict the duration of return to work. Throughout this process we have been examining the research to help us identify the indicators needed for the model to be most effective. One such study that has proven particularly interesting was ‘Predicting Return to […]
May 2016 – Measuring Self Esteem
A vital tool for disability insurers is the ability to measure self-esteem, to help separate the medical issues from the psychological issues and assist in the return to work process. Trying to better understand the complex interplay between the physical healing process and the mental health issues is hard using traditional methods. Claim managers in […]
April 2016 – Linking Physical and Mental Health
Mental health is still largely misunderstood in comparison to physical health, but we are getting better as a society at seeing the link between the two. Improvements are being made, but less has been done to reflect these links in the healthcare system, social security or even workers compensation insurance. The Claim Lab has recently […]