Recording (305), saved 2026-09-22 14:29
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Length:      87.2 minutes (1:27:14)
File saved:  2026-09-22 14:29
Words:       8,341
Paragraphs:  144
Source file: Recording (305).m4a
Coverage:    the whole file, start to finish. Nothing was cut.
Breaks:      1 stretch(es) of 15 min or longer, marked in the text:
             0:57:56 to 1:13:23 (15.5 min, silence)

Timestamps mark where each passage begins. Paragraph breaks follow real
pauses in the audio. Speakers are not labelled, because no diarization
model was used and guessing who spoke would be invention.

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[0:00:00]
Yeah, yeah, because the non-intractable doesn't.

[0:00:15]
Yeah, yeah, yeah. I think it is. Not good to buy. Yeah. Here we shine again. Yeah, here we
shine again.

[0:00:35]
I don't know why it keeps going out. Can you hear me? Yeah, I can hear you. Yes, I can. Uh-
huh. All right. So yes, you're correct to remove the non-injectable. Okay. Yeah. I wasn't
like it. we are good because we have boats that we should remove in the same sentence. So I
was thinking one of them are boats. So I told him to remove boats and just leave a key
process of my post so I might be headed. Perfect. Yep, you had it. Yeah, so giving, you
know, more examples and like

[0:01:26]
really, you know, taking your time on this one's going to be important because, you know,
301 seems to be one of those ones that's the hardest to really get everyone to fully
understand.

[0:01:47]
So not only like those type of examples, but also really explaining that when it comes to
when to use them from like carrier notes and wrist management notes. Where is that?

[0:02:04]
I'll see where Iris. Okay, so updating the diagnosis for CCM or wrist management notes, they
can use them even if we have medical. So it is okay that they do that, but and that you know
they don't get counted off for it, but just making sure that they use it if we don't have
medical, because they will get counted off if they fail to use it and we don't have medical.
So, if we have medical the diagnosis, they don't have to update per CCN or risk management
notes,

[0:02:42]
They can just update from medical. So that's then kind of, you know, let's let that to them.
They wouldn't be marked off for that. So, but it does they hear this. They'll consider a
best practice to continue to monitor and update the claim per these diagnosis and case. They
are added to medical later. I have a question here, but when I said if there is a makeup
with a clear diagnosis on the claim, it's optional. So they was the interview with any
diagnosis found in CCN or.

[0:03:18]
that was medical notes. Oh, sorry, Rick smash me notes. So the word optional made me think
like in the one so they can do it, but you know that if they don't use the diagnosis to add
in the injury body part that will cause a critical error. No, it's not if there is a
diagnosis on the medical. So yeah, if there is a medical that has the diagnosis on it, that
we have to update the claim based on the medical. It is optional that they, that the
diagnosis using risk management notes

[0:03:58]
or CCN, it is optional since we have updated for medical.

[0:04:05]
But like they won't get counted off, however,

[0:04:11]
it's still considered best practice that they go ahead and just update per period notes.
Like I would say, hey, still go ahead and add the diagnosis and finding, you know,
perinosis, mismanagement notes. Because if they later get added to medical and you forget to
update for that medical, then, you know. That would be the critical. Yeah. Okay, so for
example, we have a new claim and to just enter to the new claim. We have America with a
clear diagnosis And we have a North diagnosis in CCN.

[0:04:45]
Mandatory is the diagnosis for the medical document. That is the most important one. Yeah.
Oh, okay. Yeah, so now if we do not have a medical with the diagnosis on it, and we do have
a diagnosis in CCN or risk management notes, then they do have to use the diagnosis not in
CCN or risk management notes. Okay, now I got it. All right, okay, and let's see here.

[0:05:34]
Okay, so yes, going over, showing them how to use the diagnosis codes, this, you know, this
could, would be a good place to also use a live example for using diagnosis codes. You know,
you can have them attempt to, you know, you can have like some codes that aside and ask them
to pull it out. you know, using Google or they can use the ICB code link and have them, you
know, practice following up the diagnosis codes. Also another thing that you can do is have,
and again, a lot of

[0:06:27]
of times you know as you're just doing your normal coach thing and you see different medical
documents you know take little snippets of it so like if you see a diagnosis on a medical
you can take a snippet of that put it in the chat and you know pick one that has things that
we need to remove like maybe it has, you know, in VA on it or something, or, you know,
subsequent encounter things, you know, things that we need to remove and just put that in
the chat,

[0:07:03]
and then, you know, I'm asked them to put the, what the diagnosis should be, you know, can
do things like that. I'm gonna have a question. I don't know maybe if you know it or we can
figure out later. We always use the ICD-10 code, but at some time I see the ICD-9 code.

[0:07:29]
The number nine. I don't know if you've seen before. Like what is it? You usually have like
an R with it? I mean, is it like about the cold, right? Let me try to

[0:07:44]
I mean, so we always use ITD 10.

[0:07:50]
Let me show you here. Let me just create some.

[0:08:00]
So the normal diagnosis we use is the ICD-10 that is always we use. I mean that is the
normal diagnosis we find in the American document. But sometimes I saw some diagnosis with
the ICD-9. I mean, I don't know if you've seen before, I saw it some time, but I remember
that moment I tell the agent I use always I see the same, but I don't know if you know what
in the or do you bring in maybe or? Well, let's see. Oh, maybe we'll have to ask who our
friend will be.

[0:08:42]
Yeah, I was willing that. And basically it says that it's like a kind of hierarchical
organization structure. The ICD-9 uses three to five digit numeric. And the ICD-10 just used
three to seven character. And basically, the difference is the nature of the injury. So
basically, the 10 is more explicit than the 9, because the 9 includes, like, it's not so
explicit, basically. That's what I find. And the updated highly detailed medical diagnostic
coding system that replaced the older limited ICD-9 system in the United States, I'm not
talking about it.

[0:09:36]
So the ICD-10 is the most updated one. The most recent, yes. Yeah, it sounds like, you know,
if that is what they use, it should still be fine. just sound like they updated the system.
They upgraded from a 9 to 10, but as long as it still falls under one of our accepted types
of diagnoses, then that should be fine. Okay, just thinking to futures, maybe that happened
and maybe I got that question. Yeah, that's okay. Do you remember what the diagnosis then?
Like was it like a weird diagnosis when you looked it up,

[0:10:27]
or did it seem like kind of like a normal, like ankle sprain or, you know, something like
that? Okay. Or do you remember what kind of injury it was when you looked up the diagnosis?
No, I was pushing the door because it's like a truck or somewhere else that's really down. I
just closed the door. No, I don't really remember what was the injury. But I noticed that
the ACD-9 was like a really sure. And the ACD-10 was like more specific. I do remember that.
I remember the specific part of the body.

[0:11:06]
I don't remember just like that the nag was like a really sure like like like general like
uh yeah like something you know about the 10 was really specific. Okay oh so they did have a
one with a nine and a 10. I'll say it. They had one that had a nine and then they had one
that also had a 10. No I just remember one case. I don't remember one of them. Now just
talking about these but I just made me remember about that. Yeah, no worries.

[0:11:39]
All right. Um, let's see here. Um. Um, all over the neighborhood. and down next to the side,
and especially back up next to the side.

[0:12:11]
All very parts, one identified on the number of calls.

[0:12:23]
Okay, yeah, I love that we added what is a conservatory injury.

[0:12:30]
Nice.

[0:12:36]
All right, so one thing that I would let them know that has come up before that I've seen a
couple of times in the chat. We never update the. What is that one? Not what was I'm
probably doing. We can update that. Oh my god, come on. It's done. We love our update. Oh,
what happened. I'm gonna get this. Okay. So because that has been asked more than once. So
let me describe this whole random claim. So yeah, so we're going to show them, you know,

[0:13:27]
One, again, we always want to make sure we review this, but it is never to be updated. Even
if it's unknown, we are not updating it to say NA.

[0:13:39]
We only want to modify the 301s, which is audit and APT or what was the entry illness and
then what was employee doing. If they put unknown here, we don't care. We're not going to
touch that part. But again, it is important that we read what happens to get the full story
of the claim. I have a question here. I don't think that's it that before, but we never turn
to use anorefield to what was the employee doing just before, right? I mean, we always use
what was the employee doing

[0:14:19]
or what happened, depending on the case. So they, the agents, just the agents, right? I
mean, I know you use one of their fields to avoid what they've been doing before. Or that
can happen. We don't update it to anything except for NA. Like so if what was the employee
doing said unknown or I don't know, they don't remember, you know, something like that, then
we will update that to say NA, but not. We send the NA. Yeah, but we would not update it to
say anything different

[0:14:51]
than that. Yeah, I mean, I was thinking about that. I mean, we only use their fill, so
they're just the object. I mean, we never use, for example, use the object so they won't
deploy doing, I mean, no, I never see that before.

[0:15:04]
Yeah.

[0:15:06]
Right now,

[0:15:10]
we would not ever update that to anything, so for instance. Yeah. But the object, you're
correct. Yes, we can use that. I mean, we can update that to something other than an NA. We
can take to what was employee doing if it that an update the object and then with code
commission we can update the object with the what happens. Okay. And then let's see here.
Okay, so then, and then also, you know, remind them that if it says blind app, you know,
that's fine, then we tend to get a lot of questions, maybe not a lot, but I've seen, you
know, more than a couple times where they've asked, if it says blind, I need to change it to
NA.

[0:16:09]
Yeah, well, I'm not saying, and then we'll see here. Let's just we'll go over when we do
change it to NA, then we want to make sure to send that email out to help and safety. And it
wouldn't even hurt to also give him a quick little example of similar verbiage, you know,
who says similar verbiage here. Yeah, like, for example, there is no object causing the
injury for it. That is a, that's a verbiage for us saying that it's numb. Uh-huh. Yeah. And
then we need to focus on that.

[0:16:52]
I mean, efficacy and that part because they, maybe that you see that it's a test there and
just leave it like that. They didn't care to read. that is similar to every saying that is
not odd yet. Yeah, yeah.

[0:17:05]
That's exactly, let's see. And then also, if management does reply, giving us the
information, then update it.

[0:17:17]
I don't see a whole lot of management replies, but. No, I just see like a few, a few times
in the email. I'll also share it with that's it. Yeah. Yeah. That I just noticed with the
trio ones is that usually when well they they usually don't answer us or they don't provide
a response but sometimes when I enter to the timeline I can see that there are some
applications on some claims and they change it by their own. Yeah. Yeah. sometimes they do.
Yeah, that's another one to point out also because they not only that, though, but sometimes
they will go and change our injury nature body part.

[0:18:09]
before it gets? Yeah so we do that one of the irises that we review does tell them that they
do need to check the timeline but that could be something to add in during this review also
that making sure that this information is correct and sometimes management may change it
back especially when they think they're like, oh, no, this isn't. This is the right. This
was a personal injury or, you know,

[0:18:43]
keep it keeping leather. Yeah. So, um, but yeah, there's that it shouldn't be touching those
things that sometimes they do. Um, and then let's see. Oh, let's see. Okay. So, and then it
gives an example here.

[0:19:10]
Okay, so this one is like an example of when the object is saying none, and then but we do
have this information over here, so we would just update that. Make sure to tell them do not
pick, I mean, Iris will tell them, but just emphasize, do not try to pick and choose the
words from here copy and paste the whole thing. And do not make any modifications to it.
Let's see. Getting missing medical provider information. Hey. Do we still sign this? I'm
missing medical provider information.

[0:20:09]
You know, I'm talking about in the in the widget.

[0:20:15]
The, um, sorry, what was your question? Do we still sign this here? The, uh, no, yet, but,
but we have, we have that, uh, and that's on, on the dashboards and they can see it on their
own dashboards. But at this time, we are focusing on the OSHA 500. So, so we, we are not
working at this time on that until we clean. the other ones. So once we clean that we will
return to work those three widgets that is missing medical information and I don't remember
the other ones but yeah they're three. Okay,

[0:20:53]
so I don't even think last training class we covered this because yeah because we're not
working on it yeah that is employee services unknown, new, there is medical treatment so as
no and the other one is missing medical provider information, those three widgets. Yes, we
stop it. All right. So then so Jonathan, that's another thing like if if it is something
where like that it can be easily learned and iris, but that's not something that we've done
in like months, then I would I do skip

[0:21:33]
over that because they're already going to be already filling them with so much information.
So I don't want to do the same with COVID claims. I don't go over the whole COVID process
because we don't really get COVID claims like once in a blue moon, we might. But if we do,
then they can consult a coach. And, you know, or review iris for that. because at that
point, they should, you know, be able to follow the steps just fine. But I don't want to
shove a lot of processes in there

[0:22:12]
that we haven't done in months or, you know, things like that because it's already a lot.
So, but this one's pretty simple that if, you know, if it's something that we're about to
do, like once it comes to training time or we are currently working on, then I would go
ahead and review these steps with them.

[0:22:36]
But it's not, then, no. Not going to do that.

[0:22:44]
Because they're going to forget by the time they get to it anyway.

[0:22:49]
So, health and safety escalations. So this is just going to be for them to know how to to do
yeah to well it says for third requests but I think we just kind of copy and paste it this
into a lot of the iris articles but this one is specifically just telling them how to find
the health and safety person and those these are these steps because they have if they need
to send the email to health and safety because of the 301s then these will be

[0:23:27]
the steps on how they can do that. So, um, and then, um, again, it can be, you know, um, a
hands-on type of thing, uh, where you can, um, either just kind of show them the steps,
like, go through the iris, but then show them how, you know, what it looks like to go
through the claim, um, and or have, um, have one of them go through it. Yes, and, and
journey, something, something that usually we do, When once we end this part on training is
that we get practice on this so we we found like claims and we say like, hey, what is the
manager supervisor for the, I don't know if the region 10510 is an example and they tell us
what is and based on what they found that we can do it like three or four times.

[0:24:22]
and yeah, that's a good practice that they can have in order to know how to access it and
how to find these specific employees or supervisor. Yeah. Right. Yeah, and it's just good to
do these things because not only does it allow them to practice, but it kind of breaks up
you talking at them, you know, so, you know, because you're, I'm telling you, make sure to
have some water because they can talk so much.

[0:24:57]
But yeah, it just kind of really breaks that anile and allows them to get engaged into
things. So, you know, they're not just like sitting there and listening, but they finally
have that moment of, oh, okay, you know, I'm gonna do something. So it breaks up that I
guess kind of the boring part of training for them. Yeah, because we don't get to do like a
whole lot of hands on until they start working claims. So the more that they can, you know,
try things out up until then the better.

[0:25:37]
Yeah. All right. What's next on our list. This is what we're going to be learning,
processing new planes.

[0:25:51]
Accessing new planes to 3647.

[0:26:00]
Okay, oh, and this is the, we're working on this iris shoe. So it's going to look a little
different. Just because they, they will then you provide. You're going to have to take out
one part of these ideas. Yes, this. Yeah, that part. Yeah. Take that out. And. There are
five examples of a much better thing.

[0:26:42]
So, it's not that much, but it's not that much. with the space by family.

[0:27:10]
One, two, three.

[0:27:23]
I was going to try to just pull up the one that I sent it.

[0:27:32]
That's not the thing.

[0:27:43]
Okay, well, that's spinning. Okay, I'm just going to come over here. So processing new
plans. I'm sure I didn't know. Okay, yeah. So on this one, we're going to go through the
Iris article. But with doing that, I still like to have a claim for them to see instead of
just kind of going through all the steps. So it's like I do go back and forth quite a bit.
So and also I don't review this part just yet. Because they won't completely. Yes. So
because this is the part that's

[0:28:41]
telling them to avoid creating unnecessary or excessive tasks. So I don't really want to

[0:28:48]
do that and like review this part until I've gone over every type of task with them. If that
makes sense. So because I don't want to say example for RDS and then what's an RDS and then
I, but they will lead you to the RID. So what are the last time in the case, you know, so I
don't go over this part just because most of this they're not going to understand what it
is. So yes, so I don't I will skip this part because this part is also new newer to this
iris. So so I skip right now here to first review of a new claim.

[0:29:39]
And as you get familiar with like the Iris articles, you'll start to, you know, you'll be
able to kind of skim through. And another thing this is part of like the like before class
stars, just kind of the or even the day before kind of review what you're going to, you
know, go over and then you can quickly see like, oh, you know what? When I get to this Iris,
I'm not going to review this part. I'm going to go ahead and skip down to review how to
review a new claim.

[0:30:07]
And then go. Okay. Um.

[0:30:36]
Okay. Did you close everything? Taken forever to pull up. What did you say, Jonathan? No, I
was thinking that you close everything. Oh, no, I was trying to open up the. The word doc
that I for the processing new claims and have the modifications on it, but it is just taking
a long time. So, um, but that's okay. I'll just keep on going. So, um, first thing, you
know, you can tell them to select a new claim. And again, this is where I always will have a
new claim.

[0:31:16]
To show them as I'm going through these steps. Okay. Okay, and then so as you're kind of
going through the the steps, so open the new claim, that was assigned to you by a coach, and
then why you're taking a point and I use you would show, you know, a real moment with a new
claim. Yeah, so each step I'm going to then show them. So I'm reading through each step and
then I'm showing them. Okay, you know, that's perfect. I'm on those steps. Yeah. So look for
other active claims for the employee. So want to show them how to do that.

[0:32:03]
And then if you want, you can either have, like if you don't want to go back and forth on
your screen, you can either add. You can either ask someone from the class to read the
different steps, or you can always ask your co-trainer to redo the steps for you, and then
you just do the actions on the claim, completely up to you. I usually just do both, go to
Iris, then pull over my claim, and then show them the steps. Okay, so let's see here.

[0:32:50]
So, you know, go through each step. And then they have the the visual here. As well for the
recent claims. And so basically, I mean, I don't. think I need to go through all of these,
but one important thing is making sure, and I know this is like

[0:33:21]
they tend to get away from trying to go and use iris, but

[0:33:29]
we need to make sure they stick with it because they will try to just, you know, work from
memory a lot. But, you know, and I get it like they feel like, you know, they've got it
whatever, but it's important that they do still look at Iris and make sure to use these
hyperlinks because that's not a lot of times they won't use these hyperlinks. So like when
it says review the OSHA 3 ones, I know they don't remember everything about the real ones so
they should be clicking this hyperlink to take them there to remind them and to check, you
know, for those things.

[0:34:04]
things. So and then tells them to review what happened. So because that is not part of the
301, so they need to then review that. And then, you know, if it's a blind app, then they
should use

[0:34:21]
blind app, same with hearing claims, reminds them that the body diagram is for external
management use only and we should never, ever use that. And we definitely don't want to make
any updates on it.

[0:34:38]
Oh, one other thing that when it comes to new claims, I believe this says to go into edit
first.

[0:34:52]
Where is it? Yeah, so edit claim. I don't know how usually where it claims I typically don't
click on edit claim before I start reviewing a new claim. I think it used to be where we
could see more information when we were in the edit claim view. But like for example, I
think risk management knows only open when we used to have the have an edit. and edit but
now we don't have to have an edit view in order to see risk management notes.

[0:35:28]
So I my preferences, I don't like reviewing the claimant while it's in edit screen. Also

[0:35:36]
I agree with you. I mean, the only difference between the edit mode is that you can see the
And the body, the body, the, the, the, the hormones, you know, the, how do you die? Yeah,
the, yeah, the VW. So, exactly. Yeah, so why you the bone? So yeah, I go and review the clay
normal. I know they usually and it, and it claims to, I mean, to the injury body part, and
stuff like that. Mm-hmm. And now because Iris says that, and most of the time they are,

[0:36:08]
especially you know, at first they are kind of going, word for word and they do select edit
which is fine but we might just have to like remind them like hey you don't have to

[0:36:25]
And that's what I'm going to do.

[0:36:37]
Hello

[0:36:43]
I'm going to open it again.

[0:37:06]
Hello

[0:37:19]
Can you give me now, it was me. Now I can, you know, I think it says, kept saying something
went wrong. We'll bring you back to the meeting shortly. Oh. What's going on? Is my each and
there's something like that? What's happening? Okay. So not, I forgot where I was. Um, oh, I
was gonna say also, you know, like when you're in edit, no one else can, um, go into edit
and you don't want to really like lock it out for that long. So, um, like if someone else
was needing to make an update on the claim, then you're blocking it as you're just like kind
of reviewing it, which, you know, um, so I would only select edit claim.

[0:38:13]
Let them know only so that really select edit claim once you're ready to make an update on
it. Like if you're actually going to make an edit on it, otherwise just review it like
normal.

[0:38:25]
Okay.

[0:38:28]
So, okay, so then.

[0:38:31]
So first date of service. So that one, I will have to explain to them, you know, about if
there is medical. So, and then ensuring in that first date of service per medical, if we
have medical. So all they have to do is follow the steps here. Review the claim for medical
document. Is there documentation with an identical. identifyable data service. If the answer
is yes, then they're going to put that data service here. And if there are multiple
documents used, whatever is the earliest data service.

[0:39:10]
And if the answer is no, then don't update that field at all. And then if medical

[0:39:18]
is received later, then they can update it at that time. All right. And then also. I was
thinking we only use the fridge medical with the word to the service, but I think that just
apply with the working calendar. I was thinking that that was applied here too, because we
use the fridge medical with what to the service. We worked with the service. I was thinking
that we apply here too, but based on that, we only see, we only apply that We're going to be
coming there.

[0:39:57]
So your hand. Well, yeah, so this one is whatever is the earliest data service that we have
in the files. So when we're working to claim we have a medical. Then we're going to put the
data service in here, even if it's not the initial just just whatever. Like there's more
than one medical, then we're going to put whatever is the earliest data service and here.
And then now if we later get, by say if the first document we get is the follow up visit,
we're still going to put that data service.

[0:40:40]
And this filled on the claim. But if we later get the initial data service, then at that
time, then we will update that, yeah, with that data service. So, um, and then make sure
that they know we do not update it based on dates found in the carrier notes or risk
management notes or anywhere else on the claim. It has to be the actual medical document and
the files. We can't even use it based on a phone call to the healthcare provider.

[0:41:19]
We have to have the medical and the files. Okay. So then scrolling to the OSHA regulatory.
Okay. So OSHA privacy they should be opening that up because I will tell you they will try
to memorize what the OSHA privacy are. Most of the time they do get it right. with, you
know, ask them, you know, is this a privacy? You know, I just have a few options that we use
to get into. So yeah, maybe they get it right, but it's not about options to take a look to
the background. Yeah, they should be checking Iris.

[0:42:02]
When the claim is coded, OSHA 5, we don't get too many of those, but if we do, If we do then
instruct them to make sure that medical treatment is thought at yes. If we need to change it
to yes, we need to go ahead and do that and make sure to update health care provider. To
unknown if there is no HCP information already. Okay, and then, and then that is it, we'd
never make any type of escalations on it. Yeah, I would make sure to let them know, do not
send any

[0:42:44]
escalations, do not call any healthcare providers. You know, when it comes to a claim that
is at an ocean of five. All right, so now I'm reviewing medical treatment. Okay, so review
an update, treat an ER and hospitalize overnight. So it has reference, our Iris 18155 there,
which I think is the next thing on the itinerary. If I'm not mistaken, yes, it is. Okay. All
right. So, um, and then you can just let them know instead of, you know, going to that iris
at that point, just let them know, and like, and we will be reviewing this iris next.

[0:43:40]
And then, oh, yeah, I saw it in the, in the war that is in this one. Yeah. And then, you
know, and then now if treatment thought is marked no and there is no indication that
treatment has been sought and no indication that TV face yes within the claim. We're going
to follow these steps here. And so I have them do it tells them to the IRC of the claim
initial review, complete, do full claim review. Okay, I'm unsure that the ER and
hospitalizer when I are both marked at no, um, if appropriate.

[0:44:23]
And that again will be a misirus. I'm sure that our three on one bills are not blank or
unknown, etc. Is there anything on the claim that confirms TBFAS? Yes. If so, mark treatment
thought. Yes. ArcTVFAS, and send an RHPD, and then breaking calendar if indicated, create a
task, aim, and then template that we will use is our new thing of OSHA 0 node treatment. So
then it breaks down for OSHA 0 claims with a breaking calendar, and then OSHA 0 claims
treatment But unknown. So depending on which one you need, it will be which one you follow
here. Now, let me see, when we get to.

[0:45:28]
Okay, so. Thank you so much to play.

[0:45:44]
All right, okay, so we have our OSHA zero no treat so you can you can go through the steps.
I just let them know. And then you can let them know we will do a breaking. One second. I'm
sorry. He's so loud. But only a second.

[0:46:15]
That's a play.

[0:46:51]
Okay. So sorry about that. All right. Okay. So then, okay. So, and again, because sometimes
when we add things to Iris, it kind of goes off into things that we haven't learned about
with training. So that's why I was saying, you know, sometimes things may pop into the IRS
that we're reading that we have not went over yet. So when that happens, just reassure them
like we are gonna go over what exactly what a breaking calendar is and our HPDs a little bit
later. And you can just kind of give them a general idea of what those are.

[0:47:44]
Because we don't want to get to stuck on the maximum questions about it when we haven't
reviewed it yet.

[0:47:52]
Okay, so then see here.

[0:48:01]
Okay, so then it tells, you know, explain to them when the ocean. Sorry, Regina to interrupt
you. I will stop now. I will return to the meeting later on once I finish the other meeting.
So yeah, do you want to please just take notes of all the information we need to update for
the training process. The file is already on the shared drive, so you can just take notes.
Thank you, Ruchana. Talk to you later, team. Thank you. Bye bye. Oh, and then Johnny, then
also if you want, so I know I haven't taken a break or anything. Do you want to take one at
two?

[0:48:51]
Yeah, yeah. Okay. All right. Okay, so let's see here. Let's see. All right, so then at the
end of that just tells them to note their claim review and move on to the next claim. Okay,
so that's when we have these treatment thought. I'm sorry, treatment thought is marked no,
no indication of treatment and we do the OSHA zero no treatment type. Okay, so that's kind
of squished in the middle here of everything else. So then it goes down to school to medical
information. So this is kind of just that.

[0:49:46]
And I have to explain that. So this is part of number four, like this part here, because
number four has us look at the ocean regulatory information, but then like kind of
separately this process is an addition to number four. that and then it goes completes on to
number five. So if it runs into this step here, then everything, you know, you're done. And
then if not, then it continues on to scrolling to medical information. Take note of a
medical provider's name contact information. If information is present, update the OSHA
regulatory card information to reflect that medical treatment is thought.

[0:50:42]
Sproul to employee service update. And enter today's dates and initial review date filled or
use the calendar icon. Um, it does tell them to review the changes like for change requests
usually, um, like a new wave is not going to have any. So, um, so typically they won't have
any, but a more seasoned rep may so as, you know, as they start to get change requests, they
may be working on a new claim that does have a change request on it. However, when we do the
change request, I, the change requests are sent separately, but, you know, they work those
separately. So, but there may be a change request that was just submitted that day, and I, I
do let them know like if you're in a claim.

[0:51:44]
And it happens to have a change request that was submitted today. Then go ahead and work it.
But not from like your change request list. So if they're in a claim for any other reason
and it happens to have a change request on it. I need to go ahead and work it. So, they
should be checking for the change request section to see if there's any change requests. If
there are, then here's the link to processing change request. They need to review the claim
absence. If TAW less time has been started, they need to document that, make sure to move
the estimated

[0:52:32]
date out to one year. They, I do tell them to still go ahead and check the transactions
typically, you know, new claims are going to have that, but just for best practice. Yeah,
new claim, then it'll happen, but is there no brother that they always check?

[0:52:53]
Yeah, it's good practice, just so they're always kind of, you know, doing that
automatically, because if they stop doing it because it's new claim, they may forget to do
it on a follow-up claim, so. Yeah. Yeah. And then open task. Not going to have open task on
a new claim. You know, but I tell them to check the the task anyways, there might be like an
attached off task or something, so. they should check for any task and then same with notes
going over notes. There are these hyperlinks

[0:53:35]
but we're not going to review them yet so I just let them know. We will get that review this
address in a later lesson. Then emails, checking that the emails make sure there's no
additional information, such as any medical treatment for anything about restrictions or
lost time.

[0:54:06]
Then we can update the claim-based on any information we find in the email. And then, you
know, files, so the documents could contain a variety of information. So just we want to go
over check in the files. So that would bring them to using these iris articles. If there are
anything in the files. I remember the, let me see. We saw the Ayris of OSHA 1012 and we
briefly see the 3.4 and we continue with the 5. Because you said that the 3.4, we're going
to see it later.

[0:54:54]
Yeah, mm-hmm. Yes. So we're not going to actually look at these right now, But these are
here for later, like when they're... Oh, okay, okay, you're just mentioned that you can,
okay. Yeah, so like all of these, like because they're going to see them as you're reviewing
it, just let them know that we will be reviewing these later.

[0:55:17]
But yeah, but, you know, they're here when they're actually working claims and, you know,
need to actually use the irises at that time.

[0:55:28]
Okay, you got it. All right. And then this part, we've gotten rid of. See then. Okay. Let me
see how I. This here is. Okay, it isn't landscape. Sorry. The one that I. And. just has some
additional information and then once we got to hear them. So, okay, so we are going to just
have them.

[0:56:12]
We're going to remove this and then they would just use the iris one eight one five five.

[0:56:19]
Okay, so not change anything after that. No. Okay. So this won't be here. Yeah. And process
additional information. So this is review the information gathered to determine if any other
actions required on the claim, look for a breaking calendar. And if I identify, take
appropriate actions, when medical is present, is there a gap between the date of injury and
the visit date? An absence record is served. as they're dealt between the date of injury and
TWA lost time start date.

[0:56:57]
Are there any indicators of the following? TWA lost time conflicting start dates.

[0:57:04]
Does the conflicting date of injury exist? So again, these are all gonna be things that

[0:57:10]
they will learn a little bit later as well. So I break encounter indicators and conflicting
dates. Okay, and then when we get back from break, we'll go over the next, this HCP
information, and then we'll start looking at the new claims quiz. All right, all righty,
then, okay, all right, well, then I will see you in my 2015 Okay. Okay. Okay. Okay. Yeah.
You're awesome. Okay, yeah, you're awesome.

[0:57:56 to 1:13:23]  ---- BREAK, 15.5 min of silence. Recording continues below. ----

[1:13:23]
And back and back. All right. I get kind of doing the dishes. You were doing dishes too.
Yeah. Oh my gosh, I was too. I was loading up my dishwasher. Oh, man. The watershed is me
so. Awesome. All right. Oh yeah, that's another thing. Sometimes I forget right away to tell
the class. the class when they get back, put the hands on the air, raise their hands, so
that way I know when they're back.

[1:14:04]
Oh, all right. Was it okay? So we're going to do iris 18155.

[1:14:12]
Like we're pretty familiar 18155. Let me share my screen again.

[1:14:29]
So this one, um, sometimes until we can actually apply it. Um, sometimes it's hard for them.
This is like a low information without seeing any claim. So I go through it. And then, you
know, of course, we will apply it later. because really, you know, it's not something that
they'll fully understand right now and that's okay. So. Maybe we can try for example, okay,
maybe go through the new plane, say widget, maybe try to find one that applies here on the
children, children to them. Yeah, yeah.

[1:15:18]
You definitely can. Like if you can find. Um, maybe I don't know, just find one, I don't
know if you'd be able to find one that fits, you know, each one, but, you know, a couple
example claims to, like maybe some medical treatment that's yes, some that's no. I'm even
like a few that's unknown. I mean, for the first two, maybe we just just kind of like open a
new claim, just edit the right button without save any change, you just show it to the NIA.

[1:15:53]
Hey, look, for example, this part, like three minutes or no, whatever, what we are going to
do, something like that. Found the NIA in the social 3, 4 and I just moved training to know
about without saving any changes. I'm just showing today. I mean, what should I do in this
situation? Yes. That's a good idea and to show them where this is at on the claim. Where do
they go to look for medical treatment? Where do they go to the New York hospitalized? HCP
info. Just to show them where that's at on the claim.

[1:16:29]
would be helpful. All right, and then now let me ask you as far as this iris do you have any
questions on it? No, no, no, buddy. All right, all right. Okay, okay, okay.

[1:16:58]
Okay, so then we come to working new claims, quiz, let's see.

[1:17:17]
And we have the quiz for this one. Yeah. So 14 points. We must add it more. Maybe there were
14 questions at first. Oh, I know the name doesn't have. I don't think. I don't know. Okay.
Okay. So I know if it can. Yeah, I think maybe we added some additional questions. And
that's why it doesn't. That's why it's only says 14. But so this is what we have for our
quiz. When selecting a new claim, if another act of claim has an open absence. What should
you do?

[1:18:06]
And then. Consult coach. Another claim for the same employee has an open task. What is the
correct action? Consult a coach. What should you do with the injury body part diagram during
the claim review process? And that's why they have to select all that apply. Ignore it. Do
not update it for its for external management use only. And then when the claim is coded as
OSHA 5, which is a following must be updated.

[1:18:47]
Maybe the HCP.

[1:18:57]
I think this one this one could throw them off a little bit because they do have to update
medical treatment sought, but this is not would not be the correct answer. So that might
throw them off a little bit which is fine because it shouldn't this should not be the right
answer. Um, so I think that one's kind of a little bit of a trick question. If the shift
start date does not match the date of injury and an absence record is present, what must you
do?

[1:19:23]
So it's a poach. And you should start an absence immediately if the claim has no previous
TWA lost time. False. I don't think I like that question. Okay. PWM last time record should
be extended 365 days. If that's made end date has expired or will soon. True. You should
only update. Claim builds that employees services has been authorized to update true.
Attorney file and listen in the description as an indicator of that. The mind application
process should be followed. true. Employee name and employee information should be open in
the same tab to say prime.

[1:20:19]
employee name. Information. So like where the employee's name is in blue, I think

[1:20:27]
do some updates to a lot of these questions. Yeah, because they are the most beneficial. So
when reviewing a claim for mental illness. The blank radio button that's the updated based
on the injury and the OSHA regulatory information section. So they would fill in the answer
here so they can type OSHA privacy or privacy. Either one will be acceptable. Yeah, I was
going to say that. Oh, they're going to type. Okay, okay. They're going to write down that
part. Okay, okay. So yeah, so when we set them to where they can enter an answer, like type
out an answer, we try to put different variations of how they might answer it.

[1:21:29]
So that way won't count them off. If no other claims with open absence or tasks are found
for them, ploy your next step would be to blank blank blank the claim. I don't review and
edit the claim for normal review. Why would they say that? If not a claim, we don't have to
find a claim, and then they will be to review an eddy, or maybe what they claim as normal,
working for five hours. This really wouldn't fit within this sentence, but if they put
something like that, that's fine.

[1:22:19]
But this is like basically copy and paste it right from Iris. So if they're checking Iris,
they should see that the answer is review and edit the plane.

[1:22:30]
Okay.

[1:22:34]
If medical, excuse me, if medical provider information is found, you must update the medical
information section of the plane to reflect that blank is being sought medical treatment I
would accept treatment as well and the build initial review date should be updated with
today's date and treatment sought is marked no and there's no indication of TBS the
following steps should be completed. I see the claims that the OSHA 0, no treatment sought
pass. Okay. And that is it on those questions. I wonder if there's 15 questions, why is only
14 points.

[1:23:26]
I know for sure this one's probably was added later after we did the update. after the OSHA
zero-no treatment sought was added to the process. So probably originally there were only 14
points, so it was C. Well as you can see every questions say one point, one point maybe one
of them doesn't study any of them.

[1:24:10]
The egg one doesn't have an appointment. Yeah, it does not.

[1:24:17]
Everybody's not big, I mean there is not like a big deal that will I don't have time to make
a score here, I just need to get the ray on.

[1:24:36]
No, it was it's because of the added so the name won't have any points so originally there
were only 15 questions so technically 14 because number one doesn't count as a point but
when we added the new process of the OSHA zero no treatment This question was added later.
So now there's 15 points available. So that's that's why it's just that this part didn't get
updated.

[1:25:20]
I don't know why is it not well maybe I don't know oh well I guess it does automatically um
Adam you can you can point because you have on the left no no no on the left There we go.
No, doesn't it? Okay, yeah, yeah, yeah. All right. Okay. Now. Thank you. All right. Perfect.
Yes, and I still want to go back and change some of those questions, because yeah, all
that's on there. Okay. And then our next thing is our PowerPoint.

[1:26:34]
For me this is like a difficult topic. I mean, there's not that difficult, but can be
confusing. It has like a lot of rules. Yeah, there's five rules for the breaking calendar.
Let me. This one has some animations and interactive questions and a quiz in here, so I'm
just going to