Some aspects of our claims process include:
- Prompt Three-Point Contact: Within 48 hours of the receipt of a claim, our adjuster will:
- Contact employer to confirm incident details.
- Contact injured employee to collect information on the accident, any complaints, current symptoms and medical status.
- Contact the medical provider to confirm diagnosis, prognosis and treatment plan.
- Recorded statements will be taken by the adjustor on all serious and/or questionable claims. If compensability is undetermined after the initial investigation, benefits are started under the Reservation of Rights and AlaCOMP will obtain a legal opinion from our attorneys on the matter.
- Medical Cost Containment
- We will help employers establish the medical protocol, including the designation of the Treating Doctor who will handle the initial medical treatment and any necessary referrals.
- Medical bills will be adjudicated to the prevailing state fee schedule.
- AlaCOMP pre-certifies and negotiates discount pricing for all MRIs, CT scans, ESIs, CAT scans, etc.
- AlaCOMP contracts with two national vendors to process pharmacy billing at reduced PPO rates.
- Modified Return-to-Work Programs
- Realizing that the employer’s most valuable asset is the employees, AlaCOMP works to establish return-to-work programs that reinforce the self-worth and self-esteem of the employees. These programs seek to:
- Provide support during recuperation;
- Control claim costs;
- Provide a means to maintain a productive lifestyle;
- Accept and honor restrictions suggested by Treating Doctor for the employee;
- Establish alternative jobs and develop modified duty programs.
- ISO Claims Search
- An ISO Claims Search is conducted on all lost time claims. This is used for evaluation and subrogration purposes, the determination of the employee’s claim history, and the determination of any prior permanent/partial disability ratings.
- Fraud
- Workers’ compensation fraud is a Class C Felony. AlaCOMP aggressively investigates claims cases for potential fraud.
- Post Accident Drug Testing
- Positive test results from post accident drug testing can have a drastic effect on workers’ compensation indemnity benefits. Drug tests must meet federal requirements, and must be administered within 24 hours of the on-the-job injury. Such tests can be used to determine that drug impairment was the proximate cause of the on-the-job injury. AlaCOMP will pay for any such tests as long as they are conducted within 24 hours of the incident.