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Claims Administrators far Exceed minimum Compliance Score for UR Timeliness, CWCI Reports

Thursday, March 19, 2015 | 17

Claims administrators on average scored a 97.2% in utilization-review performance ratings conducted from 2009 through 2013, far exceeding the minimum passing score of 85%, the California Workers’ Compensation Institute reports. Division of Workers’ Compensation audits of utilization-review programs check the timeliness and substance of responses to requests for authorization to provide medical services to injured workers.  “Since 2007, the DWC has been auditing claims administrator’s UR programs to make sure they comply with the state regulations, though some in ...

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