White Paper

9 Contributors to Workers’ Comp Claim Complexity

More complex and costly claims have become a persistent issue in workers’ compensation. Understanding the contributors to claim complexity is the first step to mitigating and managing these claims.

White Paper Summary

Complex claims in workers’ compensation are defined by two primary factors – cost and duration – exceeding those of typical claims. The prevailing consensus among industry leaders is that the incidence of complex claims is increasing, and over 50% of surveyed stakeholders think that complex claims are a major challenge for the industry.

The factors that can lead to claim complexity are multiple, intricate, and often overlapping. Some are more likely than others to cause complexity. Depending on the claim, factors associated with and/or contributing to high-cost claims may be unavoidable. But understanding which factors influence the course of a claim is key to identifying and mitigating risk.

 

For more content like this from Healthesystems visit their RxInformer clinical journal website.

Healthesystems is a leading provider of Pharmacy Benefit Management (PBM) & Ancillary Benefits Management programs for the workers' compensation industry.

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