Our November 2017 e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions is available!

Topics include a discussion of Can Predictive Analytics Forestall Opioid Addiction?; New WCRC Contract Negotiations Continue; Will The Opioid Epidemic Be Preventable and Reversible?. For the full newsletter, click here >> https://www.blackburngroup.com/newsletters/november-2017

October 2017 e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions

Our October 2017 e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions is available!  Topics include a discussion of The Ostrich in the Room – Data Avoidance; CIGA Win Assists Medicare Reimbursement Negotiations; Medicare Beneficiaries With Diabetes Face Challenges. For the full newsletter, click here >>https://www.blackburngroup.com/newsletters/october-2017

Juris Educational Resource Knowledge, LLC’s, NAVIGATING YOUR LNC FUTURE Conference

All Legal Nurse Consultants (LNCs) interested in furthering their career and gaining valuable insights into the legal case management industry, should consider joining Juris Educational Resource Knowledge, LLC’s, NAVIGATING YOUR LNC FUTURE Conference on October 5-7, 2017.

The conference topics will cover:

• ·       Injury and Causation
• ·       Analyzing Nursing Home Cases
• ·       Catastrophic Trucking Accidents
• ·       Blunt Abdominal Trauma
• ·       Digital Evidence from Electronic Medical Record (EMR) Systems
• ·       Major Burns – Outcomes & Damages

For more information about the association and conference, please go to www.jerkconference.com.

Blackburn Group, Inc. supports Juris Educational Resource Knowledge, LLC’s mission to educate, train and assist Legal Nurse Consultants for excellence in the risk and claim settlement industries.  

General Damages – Pain, Suffering and Emotional Distress

The definition for general damages is generally understood to mean compensation for the non-monetary aspects of the specific harm suffered by a claimant. This is sometimes called the “pain and suffering” award for a claim.

General damages are typically awarded for claims involving a personal injury. Examples of these damages include physical or emotional pain and suffering, loss of companionship, loss of consortium, disfigurement, loss of reputation, loss or impairment of mental or physical capacity, loss of enjoyment of life, etc. 

In this article of our series https://www.whatisyourclaimworth.solutions/ , we’ll discuss the key information associated with measuring general damage associated with a claim.  The determination of general damages is one of the most complex and elusive areas of damage valuations.  There are several issues to consider before beginning to calculate a general damage assessment including: 

• The specific unique circumstances of each person related to their injury. These circumstances involve any non-economic factors which impact the current well-being of the individual.    
• The causes and conditions of the injury.
• The ability to work and maintain the activities of daily living (ADL), such as household chores and recreational activities.
• The ability to have close relationships with family, friends and support persons.

Various medical, financial, and legal experts may be needed to understand and assess your unique circumstances now and into the future.  Additionally, specialized software and similar circumstance benchmarking may be needed to substantiate the value of your claim.  Some of the key factors to determine the value of your claim are:

• “Pain and Suffering”, referring to the physical pain and related issues that someone experiences after being involved in an accident.
• Emotional distress, which can take the form of mental anguish, depression, anxiety, and/or insomnia.
• Lack of consortium and companionship, which may isolate an individual and lead to other physical and emotional maladies.
• Understanding how your current financial circumstances, expected retirement and life-rated ages will be considered for your claim.

If you or your advisors (attorney, accountant, insurance) have accurately determined your special damages, then add the total amounts to a planner like our What Is Your Claim Worth Solutions https://www.whatisyourclaimworth.solutions/ for an estimate of a possible general damage value.  This amount should only be considered a starting point to be further analyzed and negotiated with your special damages.  If you are having difficulty or need assistance with this type of analysis and planning, please contact us https://www.blackburngroup.com/contact-us  for additional help. 

New Medicare System To Fight Medical Identity Theft

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires Medicare to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.  Recently, the Centers for Medicare & Medicaid Services (CMS) have announced a process to execute this fraud protection program.

A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status beginning next April.  Currently, CMS use an SSN-based HICN to identify people with Medicare to administer the program.

The enhancements include:

•         Protection of private health care and financial information, and federal health care benefit and service payments
•         Unique, randomly generated, "non-intelligent" characters which are not associated with any other personal identification numbers (PINs)
•         More current systems to minimize cybersecurity threats involving medical identity theft

For more about the system and plans for implementation, visit CMS’s website describing the program >>

Our July 2017 e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions is available!  Topics include a discussion of Special Damages – Current and Future Lost Earnings; CMS Takes Steps To Expand Liability And No-Fault MSAs; Can US Health Insurance Become More Efficient In The Future?  For the full newsletter, click here >>

https://www.blackburngroup.com/newsletters/july-2017

RiskPro June 2017 Newsletter Topics

Our June 2017 e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions is available!  Topics include a discussion of Special Damages – Property Damage Expenses; The Secondary Payer Advancement, Rationalization, and Clarification (SPARC) Act; Algorithm “signals” for healthcare services and insurance.  For the full newsletter, click here >>

https://www.blackburngroup.com/newsletters/june-2017  

RiskPro May 2017 Newsletter

Our May 2017 e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions is available!  Topics include a discussion of Special Damages – Future Medical Expenses; CA Workers’ Compensation Kickback Scheme; An Innovative Test That Predicts Chronic Conditions.  For the full newsletter, click here >> https://www.blackburngroup.com/newsletters/may-2017

Newsletter April 2017

Our e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions.

Enterprise Risk Management (ERM):

Special Damages – Past and Current Medical Expenses   

Generally, the definition for Special Damages is the monetary losses someone incurs from an accident such as medical bills (past, current and future), the cost to repair damaged property, and lost earnings.  Learn the key information associated with measuring past medical expenses incurred for a claim. >>

 https://www.blackburngroup.com/homepage-latest-news/special-damages-past-and-current-medical-expenses  

Claim Settlement, Medicare, and Medicare Set Asides:

Medicare Will Start Using New Life Tables on 4/1/17

On March 8, 2017, the Centers for Medicare & Medicaid Services (CMS) announced they will begin using the Centers for Disease Control (CDC) 2012 Life Tables on 4/1/17.  In 2012, the overall expectation of life at birth was 78.8 years, increasing from 78.7 years in 2011.  For more information about this important change, please click here >>

https://www.msariskpro.com/medicare-set-aside-news/medicare-will-start-using-new-life-tables-on-4-1-17  

Healthcare:

Should Pain Scoring Be Eliminated As A Vital Sign?

Last September the American Academy of Family Physicians (AAFP) 2016 Congress of Delegates voted to eliminate pain scores as the "fifth vital sign."  Subsequently in December, over 2,100 doctors and nurses participated in a Medscape online survey asking if they supported the AAFP vote.  For a summary of the story and a link to the study, please click here >>

https://www.blackburngroup.com/riskpro-news/should-pain-scoring-be-eliminated-as-a-vital-sign  

What  Is Your Claim Worth? – Learn the value of your claim(s) or expected claim(s); CMS Addresses Opioid Misuse with Focused Strategy to combat opioid use disorder and addiction from injuries and diseases; New Study Recommends Best Treatments For Back Pain.  For all of the news and links, please click here >> http://www.blackburngroup.com/newsletters/march-2017

Our February 2017 e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions.

Enterprise Risk Management (ERM)
With the changing landscape of political, operational and financial risks, ERM has taken on a whole new set of strategic factors to consider for organizations. Traditional definitions of ERM still apply, however practitioners must become more focused about the implications of an expanding set of issues to face in an increasingly riskier world.
What are the key questions to ask yourself or your clients about 2017 risk management topics?  Please click here to learn more >>
http://www.blackburngroup.com/homepage-latest-news/what-does-enterprise-risk-management-erm-mean-today  

Claim Settlement, Medicare, and Medicare Set Asides
On December 21, 2016, the Centers for Medicare and Medicaid Services (CMS) announced a Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) “Re- Review” Process. Additionally, CMS has updated TPOC timelines and amounts for No Fault, Liability, and Workers' Compensation claims.
Gain the latest information from CMS about these important topics by clicking here >>
 http://www.msariskpro.com/medicare-set-aside-news/msa-re-review-process-and-reporting-changes  

Healthcare
Do you or your patients suffer from debilitating headaches that affect their work and lives? An interesting new study of the comprehensive Interdisciplinary Method for the Assessment and Treatment of Chronic Headaches (IMATCH) program at the Cleveland Clinic shows promising results.
If you or your clients are experiencing cases with chronic headaches, please click here for a description of this program >>
http://www.blackburngroup.com/riskpro-news/chronic-headache-study-reveals-beneficial-treatments  

Blackburn Group, Inc. January 2017 Newsletter; Enterprise Risk Management, Medicare Set Asides, Heathcare and more

With the growth of smartphones and internet connections, telemedicine is eliminating time and costs for healthcare delivery closer to the immediate patient needs.  Also, a recent legal case determined that the Medicare Set Aside (MSA) funds were not a “countable” resource for Medicaid eligibility.  Finally, learn about how patients with multiple chronic conditions (MCCs) drive significant costs.
For all of the news and links, please click here >>
http://www.blackburngroup.com/newsletters/january-2017