News

Retro Claims Manager saves the group from significant benefit overpayments

Nancy Barnes, Manager of Claims Administration, recently saved the Retro group significant payment amounts by paying close attention to details of two claims.

In the first, she saved the group $16,359 on a case involving a worker who needed ergonomic equipment following her carpal tunnel surgery. To save the money, Nancy needed to close the case by an April 3 deadline even though the worker had not yet received all the ergonomic equipment ordered for her.

After contacting Labor & Industries, Barnes succeeded in getting the department to accept that the claim was not going to be as costly as projected. She also worked with the employee’s vocational counselor to close the claim by the deadline, which resulted in even additional savings to the Retro group.

In another case, Barnes learned that a worker who had undergone shoulder surgery was working while collecting time loss benefits from Labor & Industries. Upon further investigation, Barnes learned the employee had obtained a medical procedure not authorized by Labor & Industries. The employee did receive benefits, but Barnes’ involvement in checking details resulted in a $22,741 savings to the Retro group.

Our experienced staff of claims adjusters and managers routinely scour injury claims for inconsistencies that would result in improper or unnecessary benefits. We congratulate Nancy and the entire claims staff for their diligence in protecting the Retro membership from improper claims.

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