Recording (309), saved 2026-10-01 13:05
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Length:      180.0 minutes (3:00:00)
File saved:  2026-10-01 13:05
Words:       18,758
Paragraphs:  353
Source file: Recording (309).m4a
Coverage:    the whole file, start to finish. Nothing was cut.
Breaks:      no silent stretch reached 15 minutes.

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]
Hopefully when it moves, it'll be user friendly and won't take as long to pull up over the
same. Oh wait, I got this connection from the BPM. Maybe that is the way it's taking solo.
Ah, yeah.

[0:00:28]
And I didn't see the time I was, I, I, I took my lawns and I was in the bottom of the
abrosion when I see the tide, oh my god, I need to rush. It's okay. I was doing the same
thing. I was trying to get dinner started, actually, I was trying to throw it in the crop
pot. So I'm like, down to the last minute, I'm like, running up, you know, running upstairs
to log back in. Oh god. Okay, I'll be there. It wasn't the only one. No, I felt under
pressure like on one of those

[0:01:08]
cooking shows where I never really happened to everything.

[0:01:23]
Okay, finally see to disopen going to

[0:01:29]
open the Microsoft Edge

[0:01:35]
Oh, there we go. That looks better.

[0:02:43]
Okay, what do you think he is?

[0:02:50]
Did you get it for me? I recommend that she there is no claim

[0:02:58]
Yeah

[0:03:04]
I think I did it that one because I think it mentioned before a string I'm thinking now it's
based on the service now. Well, on once again, let me share my screen. I'll put it.

[0:03:34]
So do the reps know about as far as I see them, do they know about the instructions here?
Oh, no, no, no, no. Okay. All right. I'm just curious on that. So I think that got added
last month. I don't really remember. They will talk about with them about this bar.

[0:04:05]
Okay, so this is something new. So, one of the things I had need to do in the. What's the
next? Sure. I'm just meeting. I think it's. I think it's next week. Yeah. I think it's. We.
Um. Oh, wait. You talk about. With me about the email or. I think they were something else.
We saw something yesterday that you also wanted to bring it up in the media because it was
talking about like email and tag, but there is no email. Oh, no, no, that's, yeah, that's
different, different, yeah.

[0:04:46]
It was, I was trying to remember, it was back when we were looking at the DDEs and IDEs. And
I was like, I could have sworn we made a process for, for ICM because I questioned, I said,
okay, well intake, they have a process when they come across a medical document in. He's not
playing this. Yeah, there's no claim, but what about when ICM has that issue? They need to
have certain steps to take in order to resolve that issue. So that's when we had this added
here for instructions for ICM when there's when they have an IDE, but there's no claim for
the document that they have.

[0:05:41]
There's no template yet for that. So they would have to copy and paste copy and paste, but I
think we can get the template done because I don't know when that would even be reviewed
with the team. And then next year, I'm just meaning I'll just get with P and then ask him to
create that. Usually it doesn't take him too long to do these and usually don't pretty fast.
So, um, so maybe after that.

[0:06:17]
I'm thinking.

[0:06:20]
So you're ready to review that so that we can implement this part of iris. Welcome. if you
want to do it before the career in the template or after. I think after would be easier.
Okay, okay. Yeah. I mean, it's not like really long. I mean, just if that happened because I
don't think that will be often. But yeah, just in case it happened. Yeah. You know what to
do. But wait, so one minute. The email will send in the claim that was attached to the
document.

[0:06:59]
Yes. Okay. So we would have to. So the thing is we would have to. We would send it from the
claim, but. Let me see here. For example, this can happen for if I incorrect employee or
maybe for the same employee for the claim by a different injury

[0:07:30]
It can be the same employee. Sometimes it's not, but yeah, sometimes it's the same employee.
You know what? I think the perfect case for this one because I see in this like not that
often, but I seem like a few times. For example, when the employee has a lot of really old
claim they have a new injury but didn't create the claim and they just attach the new as
medical to the old claim. So we need to open the sequence because we need to but we were
waiting for management create a new claim.

[0:08:01]
Right. And it would be for that and also those right versus left where we never hear
anything back. So we have that the last step for them. Okay. Okay. You know how we have like
the ID, they have to ID it, but at the same time it's like, oh, okay, well, what do we do
with that after that? So, if I'm not grown, when that happens, when the escalator, like, or
all the way for the South China, there is no response. I think, like, I, I showed the agent
to just go ahead

[0:08:37]
and escalate our HPD, is just to comfort the employee, really is extremely worthy, everybody
part on the claim. And now, with that medical, that is correct body part, or conflicting
body part, we will send this email. Yeah. Okay, okay, okay. it would work for the
conflicting body parts, it would work for, well, I mean, I guess it would be conflicting,
but like a totally different date of injury, that might be attached to, sometimes management
doesn't create a claim, they just attach it on there. So it could be for that as well.

[0:09:11]
So also working for the IDE medical and preshive the, sorry, preshive not predated DOI also
too.

[0:09:22]
Yeah, or I mean, I was thinking because yeah, well, I know we send the suppression, but
sometimes they didn't suppress the claims at all. So maybe this could work too. Yeah,
definitely. I mean, I'm possibly sending both. So yeah, maybe we'll tend to quicker the
response maybe. So we can come back to that. That's just something new and I wasn't sure if
I believe there was third email sent on that, I would assume so, but I just wasn't sure if
it had been discussed with the team. Okay, so but this part here is for the intake group,

[0:10:10]
And I wanted to check something here, 19078.

[0:10:22]
All right, yeah, all right, this one, make sure that was on there. Okay, perfect. Okay, so
sorry, I just wanted to check on that real quick. But I will bring it up in the next
resource meeting so we can get that template. I'm also the ID he's in this agenda. Actually,
I don't think so because that was just done last month. And therefore, I don't think it's
updated on this one. So because I was thinking, which party should be included?

[0:11:03]
One night, it's 078. Maybe it needs to attach and support the document, but it really, on
that one, it can be down towards the bottom, because. OK, OK. Yeah, it can fall, let's see
here.

[0:11:26]
Where's the one where we review the ID ease or a DDE's

[0:11:36]
That's in support 23615 23615

[0:12:05]
I don't know what I just read. I was writing to you because it shows that you're wearing on
a hole. I mean, yeah, I pressed something on accident and I didn't realize and I was just
talking and I look back because I wasn't getting the response. I was like, oh, man. Sorry.
Okay, so it can go. You stop churning what by the way. I what? You stop churning your
screen. I did. Oh my gosh. I don't know why, I mean, you were in a hole, I don't know. I was
thinking you'd receive an article maybe, I don't know.

[0:12:42]
No, no, I pressed some button on my, like my little speaker thing. Oh, I don't know what it,
but I pressed. Okay, so we have the addressing intake errors here, so I'm thinking it can
fall right underneath right after this one here. What was that Iris? This one. Okay. Oh,
it's 19 feet. Yeah. It's.

[0:13:32]
Hey, hey, hey, hey, hey.

[0:13:39]
There's a column or a seed. Nope. Make a document. Wait, let me tell you. No matching claim.
Yeah. All right. I think that's a good spot for that. Okay. So, um, yesterday where we left
off, uh, the, uh, the, the, yeah, the partial series and then your, your matrix, yeah, I
really think I'm going to suggest. I don't know if everyone will agree, but I, I agree. I
don't need to argue. I agree.

[0:14:27]
Yeah. I'm like, we can really just get rid of that. It's, it's more confusing than helpful.
So that is true. I mean, yeah, yeah. I mean, there is no need to have it, to have it. It's
really confusing. And most of the Asian are scared to see the Irish. Yeah, yeah, yeah, yeah,
I get it though. Yeah, because at the end of the day, they don't understand the Irish that
matter, they will always ask that it's in chat, so. Yeah. I think so. Um, let's see.

[0:15:06]
Just. And. And. And. And.

[0:15:29]
Not to just remove the matrix.

[0:15:35]
You change them cold cold

[0:15:41]
Okay, so got that. Okay, so then after you review, hopefully by then we won't be reviewing
this matrix, but after that, then it's working new claims. So now we're at the point where
we're working claims that are OSHA 1 through 4. there's really not going to be much criteria
that we have to remove from it, but I would definitely recommend taking a look at it and
then kind of seeing if it falls under any of these that we haven't reviewed yet. So like if
it's a mental illness claim,

[0:16:22]
maybe not have it be one of those.

[0:16:28]
Let's see here. with the access, but like keep it simple. Yeah, yeah. Yeah, just just simple
one. Maybe some medicals attached. Central just need to start to value and that's it. Yeah,
so just work some of those random one through four claims. And then after they work the
claims, then we have the absence record workshop, which that's on the PowerPoint. It may
need to be updated possibly. I'm sure there is. I was thinking about the presentation
because we see I can record like really tonic time ago.

[0:17:16]
Yeah. Let me see. Where's the scorepoint for Ethel's check the number on it.

[0:17:29]
Yeah, okay, that's this one. Okay, so the absence record workshop. We've been using for
quite some time since almost I want to say almost the beginning of training. Maybe like the
first two classes and do it. Possibly. Let's see, then employees should start time. Okay, so
this still stands true. That one's fine. Goes over medical time stamps. Perfect. And I did
use this one after because after working claims because they can really, because we already
went through all the rules and then they get to put, you know,

[0:18:22]
Actually work the claims and then we come back to those same rules. So hopefully that kind
of ties it in to make sense. A little bit more. What are you about to say? No, no, no, no. I
was thinking that maybe we need to add like because now we have separate a TW and lost time
maybe a year or I don't know if the next slide, I don't know. You said add what in a
starting lost time because I know we have different. 25 were ruled from TNW in those time.
Yes, yeah. So that is in here, so we do have that.

[0:18:59]
Oh, okay, okay, okay, yeah, yeah, I was thinking maybe in the next slide. Okay.

[0:19:06]
But then we just kind of like go over these rules again. But I like the idea. So first we
see the Yeah, it is an record, now we try and claims, but now we make more emphasis in the
Tune 5 rules and that's a record within this presentation. Yeah. Yeah. Okay. And then I just
put a little note down here. Keep in mind, we're starting absence records. We can never
start on the date of injury unless they are across the night worker meaning

[0:19:39]
their shift starts one day and ends on the next day. Okay, okay, and then sources that we
can use to immediately update and the like this is in the melee update. Oopsie. The claim
absence. Okay, and then that's going to be an iris article 236267. So, let me know about the
files, change requests from management emails from management, and phone calls from
management.

[0:20:25]
And then this one here is going to be at our example of the TWA offer and you let them know.
I see the visual of making sure that it has a start date. And then this is the TWA offer
that does not have a start date. And we so want to let them know that we cannot use it to
start TWA or accept it as a TWA offer. This is the last time form that we used to see every
now and then not so sure we see it anymore. I haven't had any questions on it lately.

[0:21:08]
To be honest, I never see that. Okay, all right, they might not even use them anymore. So I
don't know. But if they did, then we can go ahead and use it. Let's see here. This one goes
over work status and I'm talking about footwear. So this example is where it's in the work
status is full duty. while in the boot. So if there are requirements where any type of boot,
cast, post-op, shoe, surgical, shoe, we're going to code that STAW. Ira says could
potentially mean TAW, but we're going to code most severe, making sure, of course, to check
the employees EJF.

[0:22:07]
Because depending on where they work, if they're not like a Sorter unloader package car
driver type a job

[0:22:16]
And it won't affect their eJF. So like if it was an office Worker like ourselves and we had
to wear a boot on our butt

[0:22:28]
Yeah, it would just be regular duty for us

[0:22:32]
But if they work in a hub then and that's going to be T-A-W.

[0:22:40]
Let's see, take attention to exact restrictions and always compare the restrictions to the
employees' essential job functions. Yes, making sure that they do that. Like I said, they
stop using the EJF Iris but definitely continue to encourage them to use it because that's
how we know if it's through the restrictions. I can be the difference of a passing or
failing audit. Okay, so it's time out to ask tolerated work status and how we interpret that
as regular duty. But if management asks us to put the employee on TWR last time,

[0:23:26]
based on that as tolerated restriction, we will do that. Let's see here.

[0:23:36]
Turn to work the next day so this just kind of goes over.

[0:23:43]
How we. Well, yeah, it falls under that part of that Iris, but how we do not. Code lost
time. So we just return, if there, if it says to return to worth the next day, that's just
going to be regular duty. Yeah, because it doesn't say any solution of being a work. Yeah,
unless it's a pre shift, if it's a pre shift, then, uh, yeah, yeah, yeah. We will treat it
as missing. I don't remember missing. Not missing. So if it's a precious business return to
work the next day, then that is going to be

[0:24:24]
lost time. But I think it's college because they need to reach out. They can provide it to
comfort the zero visit. What was the intention? Let me double check real quick because I was
thinking But yeah, let me let me let me make some of those where we didn't have to call this
management that was for offers of the chief returned to work the next day, except I've
won't. Employees in prior to the ship started to help care provider must be contacted for a
verification. Oh, yeah, yeah, for a mandate conflicting in a duty status order to confirm
the duty status for the date of visit.

[0:25:05]
Yeah, I'm going to call it and provide it and everything. Let's know. Yeah, I'll be doing
that. Keep Los Angeles. Yes, yeah. I'm going to keep it last time. I would. I know it says
follow the steps for amended because I think no duty status orders that might be something
we need to come together and ask about because to me, I would say follow the call three
times and if nothing keep it regular duty and I don't think there's anything that we would
need to reach out to management about because no duty status orders like management.

[0:25:50]
So it's all the same, but after three at a time, if not look, return through it, put in a
record of duty that day. No, I don't know. Sorry. No, not keep them lost. We could still put
them on regular duty because it's giving a return to work date. But so you want to keep it
as a regular duty, but it's still calling just to just to comfort the intention for that
date. Yeah, yeah, if it's precious, if we don't get anything after three attempts, then we
just leave it how it is.

[0:26:27]
Yeah, actually, that won't save us a lot of escalation, I'm sure. Yeah, because because for
like admitted and conflicting, we don't escalate to management, no duty status orders we do.
and I wouldn't think that we wouldn't want to escalate to management based on that,

[0:26:48]
just because they can't tell us the doctor's intentions. So, I mean, they will tell us like
what they want to do with the claims or what is better for them, so. Yeah, I mean, if
management wants to push back, then we would probably have, I mean, I feel like that's going
to be like a coach stamp type situation.

[0:27:08]
If management pushes back and it's like, Oh, none of these, you know, worked. Well,
actually, no, it would be fine. If it was pre-shifted management said that they worked prior
to going to that appointment,

[0:27:24]
if they specifically said that they worked prior to that appointment, I'd be fine with, you
know, not putting them last time that day.

[0:27:36]
But I don't know. I feel like that's my own where it would take a little of the topics to
talk about. Yeah, I know. Okay, hold on. Let me just...

[0:27:57]
I'm going to get a cup of coffee. I have like a cup of goma. Oh my god. I have a little
lunch. I think it's lippy. Oh, you said you want to go get a cup of coffee? Yeah, yeah,
yeah. It really, really. I'm going to go get me a cup of coffee, too. No. No. Okay. Give me
one moment. Thank you. Okay. Yeah. No problem. Baby, and you go get a cup, too. Sure.
Everybody get some coffee. All right. All right, I'll be right back. I can still hear
everything. I'll just be in the other room.

[0:33:29]
Okay now, bye. Thank you, Roshana. Oh, thank you. We're supposed to have lunch to have
energy, but this is not the case. We said you're supposed to have lunch? Yeah, we're
supposed to have lunch to have energy, but this is not the case. I'll post that. Kind of
like when you work from home, especially, you know, I always end up doing something else. I
was supposed to be painting, but then I was like, no, I got to finish dinner, so, you know,
no time to eat.

[0:34:07]
All right. Okay, Fabian's back. All right.

[0:34:12]
That has gone coffee.

[0:34:15]
Now we're ready.

[0:34:19]
Delicious. Okay.

[0:34:26]
Watch a lot of coffee YouTube videos. or they're making different coffee drinks at home.

[0:34:33]
And it inspires me.

[0:34:36]
It actually tastes a lot better than the coffee shops a lot of times. Nice, cheaper. Yeah.
Yes, very much so.

[0:34:47]
Okay, so, oh, okay, so I added that to, okay, so we're adding this part here to question it.
So, which option should we do? Three attempts and most severe. And honestly, if we agree, if
we all agree with three attempts and most severe, I think that that can just be added to
this iris instead of saying, follow these steps. I think we can just say three attempts most
of you push back consult a coach. Yeah, because I would maybe be confused for then now they
sound like it's going

[0:35:45]
into management maybe. I don't know. Yeah, I mean, it would be better just to say, call I
agree. I agree. All right. So we'll see here. All right. So this one's a question and
answer. So when you're actually presenting this, it will come in here. Let me go to like any
major. Oh, like a transition. Yeah. So it'll. Here, let me go to like any major. Oh, like a
transition. Yeah, so it'll. Oh, no, no, no, okay, this one. No, I'm. So it's supposed to,
but I think I didn't use this one because because the animation, so.

[0:36:34]
Um, this one can be fixed. I just didn't do it because I still had my my previous slide. So
I just use that. Um, but what's supposed to happen is it's supposed to come and let the team
answer. And then, um, and then you'll come up with the answer after everyone answers. And
then once you answered, you know, get the explanation of why, of course. course. And then
the same with this, it'll just come up with the next question, allow them to answer. And
then once everyone answers, then you'll put in the actual answer.

[0:37:17]
Okay. Same thing. So let's just, okay, so this one is the same thing. So they're, you know,
looking at the medical so you give them data men dream data service shows an employee can
return to work on 1213 or once evaluated by an ortho. I will tell you usually there is going
to be confusion with this because because of the wording on this medical. But the medical
does not say this, but this is the extra information that you will give to them employee
followed up with the ortho on 12, 28, 21.

[0:38:01]
Okay. First question is, is there any lost time? Okay, our answer that we get is going to be
yes. What date do we start it? And then we give the date here. A lot of times you are going
to get the answer of 12, 8, which is fine because that allows us to. And again, that is the
date of injury and that is, you know, assume they're not an overnight worker.

[0:38:29]
Do we end the last time or keep it open? So that's going to be the question where you'll
probably get a, you know, a bunch of different results. Because we have a transition here,
but okay. But now they, we already talked about it. Okay, yeah, if we see the, as in record,
we know about the transition from Los Angeles to the EW.

[0:38:58]
Um, okay, so, um, well, yes, but this one is more of, um,

[0:39:11]
Okay, okay, but okay, I now I see the medical really great bad the medical is not giving
like a clear return to work

[0:39:24]
Maybe return to work the 13 or once evaluated by his orthopedic or so for me is serving them
the points one or another another specialist hold on one second it because this one because
of that I had to alter my slide because of that one little piece on there hold on one
second. I mean yeah I'm either return to work or once cleared by ortho bed for me then we
need to honor a clear return to work by ortho. Okay okay hold on I'm not going to worry
about

[0:40:02]
find in my slide but what I the how it is actually updated is that part is removed so that
there was no confusion so ignore this part he will need to keep his right arm immobilized
it's more of

[0:40:18]
this part here that's supposed to be seen so he may return to work 1231 or once evaluated by
his orthopedic surgeon. What we do know is that he did go to the ortho on 1228. So in this
case, the instructions are to return to work on 1213 or once evaluated by ortho, if an
employed does not treat ortho honor before 1213, then we're able to end the last time on
that date because that's instruction of the medical provider. If the employee does treat
with the ortho honor before 1213,

[0:41:01]
then we would need to have that medical to know what the work duty status instruction was.
It's just that when they use the word, they're saying they can return that day or once
they're evaluated by the ortho. I would be to also scratch out the, he will need to keep his
arm immobilized. Maybe you like it. And the one that I use it is covered. Yes. Okay, okay.
We're going to go. Armagnon. Yeah. It is covered. Because it didn't. It didn't work for this
example. The point that this was trying to make.

[0:41:47]
So. And therefore, in this slide that I have, I crossed that part out. Um, I have a fact,
hold on one second, because if I don't make you wonder about you. Well, I want to, because
I'm not sure if I made any other updates, because I wouldn't have updated this one, I would
have updated my slide. So, give me just one second, let me go to my training folder.

[0:42:49]
Ooh, is that once on the other hand?

[0:43:00]
Found it. Okay.

[0:43:09]
All right. Oh, okay. Yeah. Oh, let's see from current slide. Oh, man, I'm shit. It's not no.
Okay. They're right sure. Well, how you do that. Oh, no! Hold on, let me...

[0:43:38]
Okay. I don't know how to school with them.

[0:43:49]
Okay, one second. I think I can figure this out a little bit. Let's see. Michael.

[0:44:15]
Then minimize this. Yeah, I could just, okay. Again. Okay. Now we're in business. Okay. So
this is what it would look like. And then. And then the questions come in. First this
scenario, then the question, answer, question, answer, more explanation. Okay, so this one
again is going to be questions and answers. So they have like the change request information
here. There is the CMC medical over here. We give them voice shift start time and we let it
be known that they're a part-time worker.

[0:45:22]
And we let them know medical data service 1215 shows time in 10 19 AM, which is post
shipped. I'm changing post shows and employee return to work on 1215 21. To regular duty.
What date do we end the CW. So they need to select the correct date that we would end it.
This is supposed to throw them off. Okay, so correct date. So that's okay. So both of these
dates are the same in date and regular duty date. So in this case, we want them to know it's
the 14th for the return.

[0:46:18]
Why? Because when we have post shift medical, we end the absent circuit on the same day as
data service. But since the change request shows the employee return to work on 12, 15, we
will end the lost time on 12, 14. We can mention that we always end the sequence a one day
before the return to about duty too. Uh-huh, uh-huh. Yep, yep. Um, but in this case, what
was thrown them, what, what they're supposed to think about because the visit was post-
shift, so normally we would have

[0:46:56]
ended it on the 15th, based on the medical by itself, because we would expect that they've
already work their shift and they're going to return on the next day, regularly on the next
day on the 16th. However, we have the change request and they gave the regular duty date as
the 15th

[0:47:20]
then we're going to end it on the 14th that falls within that 24 hour rule.

[0:47:28]
And when these two dates are the same, we use the state here. And we ended one day before,
yes. Yep, yep, and then you asked them if they have any questions. I looked and they would
say no. Oh, say quiet. Right. Yep. So, um, let me get this. I got to re situate everything.
thing. Okay.

[0:48:14]
Here. Okay. All right. So that is the

[0:48:21]
AppSense Record Workshop. And I mean, you can always add additional slides. Like you can And
like if you're like, oh, this is a good scenario for an absence record workshop, you know,
you can add a slide in there. That's that's perfectly fine. But I think maybe the transition
for us to see how you. Yeah, yeah, that would be a good one, especially like showing like
maybe one side, it'll be the transition without management. asking us to transition them so
you know how they handle that and then show them and then

[0:49:02]
do one where management is asking for us to move the employees from loss on CAW. Another
good one would probably be the situation where it is lost on to TAW but the medical that we
have is not the same data service that they're asking for them for the return to AW. And
what I mean is to show them that when the employee has been on lost time and then management
is ready for them to come back on to AW. Yes, we have to have the medical, but the medical
data service

[0:49:42]
does not have to be the same date or within 24 hours of the date that management has. It
just has to be the most recent medical visit.

[0:49:58]
You know, I'm palm out.

[0:50:01]
Yeah, I mean, that was a little but yeah. Okay, so it's just because I think that can
sometimes get confusing with them as far as

[0:50:12]
because we're so used to starting TWA based on medical, you know, on the data service and
then not going more than 24 hours. So it's like one of those situations where the employees
have been on last time. They treat, they go to Concentra on, I don't know, September 2nd.

[0:50:34]
And then management assets, and maybe their next office visit with Concentra

[0:50:40]
isn't until September 30th, okay. The September 2nd visit said gave restrictions. Management
asks us to bring the employee back to T.A.W. from last time on September 15th, okay? That
would be okay. It does not have to be September 2nd for September 15th is okay because
they're most recent data service that we have on file. And that's not a thing we have to
have the medical, but if we didn't have the September 2nd data service we wouldn't be able
to do it, but if we do, then we can do it on the 15th. The way I always explain that to them
is I mean you have

[0:51:31]
to remember that the employee is on management directed last time. Okay, so they don't have
to bring bring them back to W on September 2nd. They kept the management directed lost time
until they had to be ready and available for them on September 15th. So let's kind of
explain it that way. But let's see. All right, so we did absence record workshop. Okay, so
then we it come into the entry claim overview. All right, 22961.

[0:52:26]
All right, so this one they're not going to be using it right away because I'm sorry, I was
thinking of open claim maps and says sorry, yes, they would be. So unless they're, so on
this one, unless they're working a brand new claim, they should always be using this iris
here when working a claim. This will be like it like the checklist. This one has the
checklist on it, and as well as the general claim review, so they should always be in either
one so either.

[0:53:13]
If it's a new claim, they need to use the processing new claims. If it's not a new claim
that they're working, then they should be using the injury claim overview. Because this
again, we'll just give them the general. Show them how to review a claim. That's not new. So
one thing to also let them know once a claim becomes theirs. They should be doing a
complete. Review of the claim, including the claim timeline, okay? So that because if they
if someone else worked the claim before them and they updated something incorrectly, then
that falls on their store because this is now their claim, they have to prepare a bit.

[0:54:00]
That is true. The. Now I want to do. Um, filtering. Okay. So this just shows them how to use
the claim timeline. How to filter. Um, this is like a summary of everything. Past creation
overview. Okay. Um, and this, you know, this is in quite a few of the other Iris articles,
but it's also going to be in this one. And then here's just the general claim review. There
should always be checking for multiple active claims. Even if the claim is not brand new,
they should still be checking to see if there's any other claim.

[0:54:49]
That are open and actively being worked. I don't know what to say.

[0:55:01]
We're doing all the claim details, so if the employees terminate in, you know, all of that
in three details, the three ones, it gives them the iris article links. So like when you're
when they're working through those claims. So when you get to the point where you're working
claims that are not new, then make sure that they are using this. This, we're trying to
remember if.

[0:55:52]
Pretty sure if I'm not mistaken, we did we worked on some follow up claims. I thought, or we
at least look at some.

[0:56:18]
Yeah.

[0:56:30]
I'm not.

[0:56:34]
That's weird. Okay. Sorry. Um, okay. So, um, and what about that part of that show how to
search in worthy?

[0:56:47]
I was thinking that we did that before, right?

[0:56:50]
Which part are you coming out in this iris? Or are you coming out on the itinerary? The
internet. Yeah, the agenda. I mean, how to reach in worthy. I mean, I was thinking we
already did that. of. Okay. I don't remember doing that. Maybe for intake. Yeah, for intake.
Yes. But I I was thinking with ICM, I don't know why because I remember, if I'm not grown, I
mean, something like when they go to Osain or Tidai or something like that, they need to
check where they to make sure that it's a ray of Osain or something like that, or think

[0:57:44]
I forget that one. when they code last time?

[0:57:50]
Yeah, I was thinking they need to check wordly.

[0:57:55]
No, okay. So I was, maybe I was wrong. That's all right. No, I was trying to think of like,

[0:58:03]
are you talking about just like if, last time I started on the claim,

[0:58:09]
or are you talking, or maybe when they have to send the work day validation emails,

[0:58:17]
Well, they don't check work day too often and take goes into work day quite a bit, but I
think I don't think they truly know how to navigate through work day. Maybe not, yes.

[0:58:37]
Because they don't know, yeah.

[0:58:40]
There's no use it very often. And, um, and honestly, I don't.

[0:58:48]
I know maybe white, uh, journey saying that because I remember that to, from the first
training we take, uh, but, yeah, data, we, we don't do it anymore. Uh, I remember dairy tell
us to check where they, to see if the ones we apply a lot of time on where they appears on
leave. But yeah, we don't do it any more. Yeah, that was from the first trains. I forgot all
about that then.

[0:59:34]
All right, let's see here. Where were we? Oh, okay. We're still on that. Yeah, so it's on
the injury claim overview. Okay, so yeah, they should still be when they're reviewing these
sections of the claim, they should also be using the irises that go along with them checking
for, you know, the OSHA code details privacy case details. TBA, if needed, medical
information aimed and need to make sure that that is complete.

[1:00:24]
I always give them the tip of to truly check to make sure that the medical section is
complete, make sure to go into edit claim because that's really the best way to see it.
Yeah, because we can we can see the boats that is amazingly information because it just
collapses the field if it's not filled in. So I would show them that. This one because it
says in on the injury claim overview, this should only be done once. So when reviewing this,
let them know we only review, we only update this once when the claim is new.

[1:01:15]
So if there's already a date there or the claim has already been reviewed, we're not going
to put a date there. old claims don't don't have the date on there but this let them know
like this is only for when the claim is worked as a new claim. They should not be changing
that date.

[1:01:38]
Always check for change requests. Everything I let them know is that If there is a pending
change request on a claim that they're working, they can work the change request, meaning if
they were in the claim for an RDS, and they happen to see that a change request was
submitted that same day, then they should work that change request.

[1:02:10]
on the claim, but not to work it from like the claim, the change request widget, you know,
if it's for today's date. But if they're already in the claim for something else, and the
change request was submitted for today's date, then they should still go ahead and work that
review claim absence. So when they're reviewing the absence record and checking it, you
know, especially if someone else worked it, they should be checking the absence record
guidelines, making sure that it was started on the correct day. I'll check in the medical

[1:02:52]
and really any emails and previous change requests to see if we received anything from
management.

[1:03:01]
Transaction history. I want to make sure that they're checking that. I mean, it's like a
good practice, I'm going to check in. It's actually because we know that for new clients, we
don't have like a lot of information. It's a good practice that they see looking for that.
Yeah, yeah. Because if not like if they get in the habit of not looking at it, then they
won't look at it later. So yeah, even if it's a new claim, check those transaction
histories. Um, checking for open tasks.

[1:03:37]
Um, the same notes, emails. Um, this teaches them how to update the contacts. Oh, that's
right. I need the, okay, okay. Oh, this will be the iris that they would use for that. They
need to add one.

[1:04:08]
I'm actually thinking, we should probably add this to reviewing the medical document too.
Because there's a good chance that maybe they have more than one provider. And we need to
add to the context so it'd be nice to have those instructions on that virus as well. For
example, we can use the sample, like when concentra. This is two different locations, two
different addresses, but it's still concentra that we need to see at the contact because
it's a different location. Like with the sample too.

[1:04:49]
Absolutely.

[1:04:56]
What is that Iris member? We're doing medical better. Yeah, two, one, six, one, nine. Okay.
All right. And then they should be checking the files. Okay. Okay. And then the exiting
claim checklist. I always tell them to make sure to use this because one, it's super
important to make sure because it's so easy to have everything written in your notes, like
on your notepad and then forget to actually update the claim. So one thing that they need to
do and that I want to make sure that they do is not use the exit claim checklist to check
these things against what's on their notepad they need to be checking these against what's
on the claim.

[1:05:58]
Okay, okay. A lot of times what they do is they'll say, breaking counter, they'll look at
their notes that they took. Oh, okay, yeah, yeah, we address that. You know, absence are
here, you know, whatever, TVFA, yep, I document that. I know, like, no, no, no. Look at the
claim to make sure it's updated.

[1:06:20]
So, that's the only thing about the checklist. And then I tell them, you know, copy, paste
this somewhere, Um, you know, we're at whatever they use, whether they use one note sticking
out, okay. Yes. Yeah. And then they can modify it to, you know, if they notice that there's
something that they can to forget at that on their checklist.

[1:06:44]
But yeah, just like those key important things, making sure that they check those before
they leave the claim. Okay, that's a good practice.

[1:07:07]
All right. Oh, I don't get up there.

[1:07:17]
Okay.

[1:07:19]
I was thinking to ask something because I see you like in the point for a three that is in
the contemporaneous. I don't know is maybe, I mean, I want your opinion, but I don't know if
maybe it's a good idea to move the contemporaneous nest to the conflicting because I
remember it in that that is one part that I say that there is different from contemporary
added and conflicting like a chance to like be aware like it's different contemporary that
are conflicting word to resolve.

[1:07:50]
So right here. Yeah, I mean, I mean, just an idea, just an idea. Like maybe they know, so,
so because we're saying like, I like a conflict in these different contemporaries, so maybe
they have the idea or the question of the doubt like what is contemporaneous so maybe I
going to explain next to the ideas maybe I don't know I mean it's just an idea. No, not a
bad idea, not a bad idea at all, but I see there is a learning so maybe we want to keep it
there.

[1:08:27]
Um, I mean, that's, I don't know, let me see.

[1:08:34]
I feel like that should be fine.

[1:08:41]
Where did I go? Why don't I keep getting lost on here? Oh, okay, it's up here.

[1:08:48]
The only thing is I don't want to have too many loses back to back. So, um.

[1:09:07]
I think as long as we still get it all done before they work the claims, I'm almost one on
it.

[1:09:32]
I mean, it should be fine.

[1:09:42]
Yeah, I think that should be fine. Yeah, yeah, baby. What do you think?

[1:09:51]
Yeah, sorry, I'm a little sit back. Yeah, I agree with you guys.

[1:09:56]
All right, let's do that.

[1:10:02]
Let's do it.

[1:10:05]
Oh, contemporaneous.

[1:10:14]
In order to say up here after them.

[1:10:24]
Oh, come on now. All right, let's go. We're up here with your e-learning. Oh.

[1:10:44]
I'm going to second the. Okay, yeah. Perfect. I'll wait. Okay, we don't. Yay. All right. Is
this a PowerPoint?

[1:11:03]
Yeah, this is for the tool that we handle for calls. I didn't add it there, probably it was
added by someone else, but yeah, we can create that presentations once the right now, we
have the screen show. Right now we have the screenshot, so that's okay, yeah, we can leave
it, and we can present the AWS tool. Okay, should it be what, sorry, what is the AWS tool?
It's the tool that we use for phone calls, like the new avalia. I'm going to have my high
school, Amazon, Amazon.

[1:11:57]
I'm going to have a lot of things. I'm going to have a lot of things. Okay. Okay. So I'll
probably move. Well, it can be later about probably move it up towards top, I think, maybe.
Yeah, with the, with the, with the. With the tools we use. Yeah, we'll be over there. We're
charming with everything. to make sure they have access to everything. I'll have. Yeah,
like, I don't know if we should have include a presentation for it since it's very easy,
like, it just include like the, like, the dial pad and that's it.

[1:12:44]
So they will know how to use it. Like, it's very, very easy to use it. But yeah, we can
explain that verbally. I prefer to show for intake it is necessary since we didn't explain
how to transfer a phone call to other agents that requires more steps, but in this case,
it's not necessary to have a presentation. Okay. Okay. Um, do you live? All right. Okay. So
we want. Or should that be numbered? Oh, okay. Hold on. Our mind. We only like that. Okay.
And then we can move that to wherever I guess.

[1:13:39]
wherever we need to. Okay, so I'm going to go back up to, let's go ahead and just review the
contemporaneous next.

[1:14:03]
All right, so this one should still be fine. One thing that I would do. Okay, so yeah, we
did just update this recently in June. Okay. So I think we have that example added, maybe.
But I would say for this definitely having real medical examples. Okay, so having a claim
that has a contemporaneous medical on it so they can just like see the difference

[1:14:43]
of the two. See here yeah and then we would do the oops then we would do the

[1:15:01]
Okay. Okay. Okay.

[1:15:14]
All right, I wouldn't really find content brand

[1:15:22]
Okay, I've been just giving it a day or we didn't do the froward

[1:15:37]
This is just contemporary. Okay. Yes. Yes. Yes.

[1:15:45]
Okay, yes, you can provide a recommended CAW and recommend a lot of things and both opinions
are going to be better who decides which recommendation is for management, okay, which the
following will make completely medical opinion is not convened. If we have already missed
the word already, we need to do it between the two, okay, which opinion is considered both
alternative.

[1:16:14]
I know you see 90s but so I feel like that is contradicting what we actually do. Yeah, it's
because management is management, I mean, it's up to management, or we choose the most of
your is not communication. I remember when I first started in Leonardo and because it said
that I was like, oh, well clearly, you know, I have this concentra medical, it's best
documented, you know, it's the most persuasive. More than like this simple ER note, but
that's not really how we look at that.

[1:17:12]
Um, as far as most authoritative, but I think I think that's that's it is an iris. Um, but
it's contrary to yeah. Yeah, I think it when it's referring to best stockman at reason or
persuasive, it's persuasive for management to decide. So not necessarily us. So I think
that's why it's kind of confusing as far as how we work it. it, but when it comes to OSHA,
they say the most authoritative is the best document at reason or persuasive, but it comes
down to management making that decision not us.

[1:17:57]
just go based off of what's more severe. So yeah that part I think is the confusing part of
it. So I would maybe just maybe make a note for when you're reviewing this part So it's
going to be here. If there's no information for management, so which provider they deem
authoritative, then we code most severe. So it kind of explains it here. So I would just,
when it comes to this, just make sure, you know, to explain to them. It's not based on what
we feel is most authoritative.

[1:19:00]
We go by what's most severe. management goes by what they do as, you know, best documented,
best reason, that's for management. But

[1:19:15]
if they don't tell us which one they fill is, you know, that they want, then we code most of
your Okay, so um, I said that that is true when it comes to OSHA, but it can be confusing
because, um, it's not for us to decide what's the sort of that's up for to management.
Alright, oops, where are my, there we go.

[1:19:49]
Alright, and so we can continue.

[1:20:06]
So that one, they get to choose the scenario of which one is. Yes. Employees, please.
Provided with case K zero, 814. Your restriction following day. A 15. And then play visit.
Uh, Kerna. I'm pleased. I'm lost. And then play busy. Provided a concentrate. 15. Place that
award. The following day. Play busy. Concentrate. I turn it. Yeah. Um, let's see here. All
right. All right. So then. All right. So we. Oh, wait, wait. No. That out of here. Yeah.
That is indeed. Okay. Okay. So I was looking for that Iris and take earlier on the agenda,
but okay, so we reviewed

[1:21:09]
contemporary and is let's get back down here. So showing how to search and workday is just
really a basic simple search. I, I, the same group really doesn't do too much in work day.
But to kind of show them just, you know, simply how to see things. So, um,

[1:21:35]
like if I'm on this claim, I'll probably have to refresh. Let's see.

[1:21:48]
So, I can... Okay.

[1:21:58]
All right, so just to kind of show them a quick review, like, so this employee, let's see
here, this will help with things like, like employee status, like maybe if they're supposed
to be on, you know, lost time, or this is we return to work or something, and we need to
kind of see. we need to kind of see if, you know, what work day shows.

[1:22:33]
Then we can show them how to find that information, how to see the employee status. So if
you come here underneath their name, it'll stay on leave if they're on a leave of absence. I
wouldn't really go too far as far as going to worker history and showing them all of this
because at the end of the day, they're not going to make the updates here. You know, the
only thing they really need to see is, you know, if the employee is showing on leave, if
there's any issue, like maybe they're showing on leave,

[1:23:12]
but they shouldn't be, then they can ask us to look into it and we can check and make sure,
see if they're on work comp or not, maybe it's another type of leave. Um, and what else? Oh,
and then also for terminated employees. Um, we can show that our, our view, right? Fit it
again. In our views. Yeah. So for, um, terminated employees, we can, um, check that it
should be on the claim, but if they wanted to, um, check here. If they happen to be working
one because they're supposed to check the reason why the employee was terminated, they more
than likely won't come across one of these because we work those.

[1:24:02]
But you know, they might be in it for something else and they might get to it before we do,
you know, so that happens sometimes. But so they should, oopsie, oh, they should be coming
over here. Oh, man, how do we get there? If I remember. Okay. Okay. Hold on. Uh. How we
already have that one. Okay. It'll trust the IRS. So honestly, I would just show them once
you get here. Instead of doing it separately. So when you're ruining this Iris, just walk
them through the steps here.

[1:24:59]
Go to the job page and all that. And then we can also show them. If an employee is on leave,
you know, it will show that that in work days well. But I don't really, I can't really think
of any other reason why they would be in looking in work day. Maybe if they're on the phone
with the employee, you know, but really at that point, they should just get a coach. trying
to teach them what, you know, everything to find on work days, that's a whole

[1:25:35]
another thing. So, I'm going to delete this part. There we go. All right. That's it in
Miracle.

[1:26:01]
First important thing, do not distribute any of our back date at medical rules to anyone
outside of our group. So local management or the district. We don't tell them about our
process for back date at medical. So, okay, okay, okay, okay, you got it like a given
explanation lady.

[1:26:28]
Yeah, like in a, that's or something like well per our process, you know, if medical is back
dated, you know, no, we don't want to ever tell them our processes with for back data
medical and the reason is because we don't want them to start using a lot of back data in
medical. getting a lot of back data medical from providers and manipulating the system
basically. So we make the exceptions for back data medical, but we don't really want
management to know about the exceptions that we make.

[1:27:13]
When it comes to how we what we accept for back data medical. I mean, that's for our
escalations also. Like, we want to make sure that we don't tell them. You know, our rule for
maximum medical sometimes. I think we only say that for our process and that's it. Um, I
wouldn't even say that I would just either. Oh, okay. Don't do the update based on, you
know, what it is. So, like if the medical is back data and they were asking for us to maybe
zero out some

[1:27:55]
lost time based on that back data medical, then I would just, if we were able to do it, I
would just do it, but not say, oh, our process is, you know, we can do that, or, yeah, I
just want to tell them anything about it because otherwise I said they would probably be
asking employees to get these back data medicals more often so that way you know they can
get rid of

[1:28:28]
lost time especially because that goes against like their facility anytime they have lost
time it's like a mark and a fine. For them, I don't know if it affects their bonuses or not,
probably does, but you know, that's why a lot of times they want us to get rid of lost time
or they want us to make a claim OSHA zero is because they don't want that reflecting on
them. So, you know, I get it, but I just don't like when, you know, they lie to us about it.

[1:29:08]
So, but anyways, just important that they do not share any of this information with

[1:29:16]
anyone outside of our group. Okay. All right. Do you have any questions as far as backdated
medical. No, I mean, it's pretty simple. I mean, I mean, it's not as simple, but we know the
rules. I mean, we need, we need confirmation from management to use the bug data day, even
for a SAR or in a sequence. Even though communication, we always use the data service as
reference. Yeah, and I remember if the employee, like if we find out that the employee did
miss time or they did work in TWA, but now they're like,

[1:29:54]
well, the medical says this, so let's say we're not doing that. We're going to code what
actually happened. If they go and get back to medical, so if the employee did lose any time
or worked in ETAW, and then they give us back to the medical for regular duty, we're going
to code what actually happened. But if we don't have that information that they lost time or
works in a TAW, then we're fine. We'll go ahead and do the regularly that they're asking
for. Okay. From right.

[1:30:45]
That's weird.

[1:30:51]
First edition for Missing Through One. Okay. Okay.

[1:31:03]
But in that part why is this down here I was thinking the same

[1:31:16]
I remember that you showed these to the team with the last wave at the last part of the
training in order to have them. This is like a kind of workshop. Yeah, they will have a lot
of questions on this one, Johnny. They will ask a lot for it to the itinerary. I don't
remember. Or I mean, um, not to itinerary, but to the. And here. I just modified. Okay. I
don't know. Okay. Let's see. Okay. Let's see. So okay, yeah. So this one here. Okay. So
missing 301. So this is going to be a workshop to.

[1:32:24]
I don't do it right after the 301 review because I like to come back to things so instead of
giving all that information, you know, right then and there. So after we learn, you know,
quite a bit, we've worked through some claims, then we're going to come back and we're going
to now do like the workshop on the 301. So, um, on this one here, I'm just going to...

[1:33:03]
Oh wait, no? Okay, where is it? I don't like this. Hold on, one second.

[1:33:20]
than this gracious. Okay.

[1:33:28]
Alright. Fabulous. Not fabulous. Okay, one second.

[1:33:51]
thing. I'll see if there's an option to dislike screens on on.

[1:34:05]
of this

[1:34:17]
Yeah.

[1:34:24]
Okay, all right. So I'll just try to drive home the 301s. All right. So some of it will be
from I or some of it's not. So I'm just going to go through the whole slides. I know you
have not seen this one. So I'm just going to go through the whole thing. Went to remove what
management has updated in 301's IMPPT if the field was entered with unknown none nothing or
similar verbiage or it is blank it should be updated with NA and missing 301 sent.

[1:35:03]
Diagnosis that contain the word unknown are okay to add as it is a medical diagnosis and
supported by the HCP. So, um, and I think in that one, the questions that we've been asked
lately, like, should we, uh, they've been asking, should we remove this because it said the
word unknown or something. And the diagnosis. Yeah. So, um, yeah, if the diagnosis itself
has the word unknown, it is okay. Medical CTN or risk management notes provides a usable
diagnosis. What management has entered and the IMBPT should be entirely removed and replaced
with

[1:35:47]
the diagnosis. If management added a body part to the claim, for example, broke left toe and
scraped knee, but medical CTN or risk management notes provide the diagnosis of left toe
fracture, we would remove scraped knee and update the IMBPT with the diagnosis. A scraped
knee should still be considered part of the claim if medical later decides to address the
knee. If management removes our diagnosis that we updated from medical CCN or risk
management notes and reupdates it with what they input initially, we should reupdate our
claim with the correct diagnosis.

[1:36:33]
And if this becomes a reoccurring issue with a specific claim, please present the claim
number to a coach with an explanation of what is happening. You can review IBPT changes in
the claim timeline by hitting CTRL F and searching for describe the interior illness. You
may have to filter through several pages to find the update. You can be marked off for this
error if an audit are in an audit if you would have seen it the last time you're in the
claim. So make sure to check the IMVPT against your notes before you exit the claim.

[1:37:12]
That will be difficult because we know that they don't really like pay attention to that
part. I mean, they updated once. I mean, I'm being like, I mean, pay attention that they
didn't get changed. I mean, what company is that part? I mean, yeah. So the thing is, I
mean, they can, they should be checking. Well, one thing I would say would be, and again,
this is just me, so I know not everyone's going to work the same as me, you know, it's fine,
but like if I have medical on the claim

[1:37:55]
and I see that the IMBPT is, because you can tell the difference between like a diagnosis
and then what management put, because it's usually going to be like a, just like that
example that we just saw where they're going to say something like broke left toe and
scraped knee, you know, that's not how doctors used diagnosis and so that would kind of make
me think like, oh wait a minute, like, did I,

[1:38:28]
me something? Yeah, I haven't updated the IMPPT or, you know, what's going on, I have
medical, but, um, yes, but unfortunately, that is just something they have to to check. I
mean, it doesn't happen often where management does that, but it does happen sometimes. So,
I mean, best to check. So, so once you remove what management has updated in the 301s, okay,
when it comes to the object, substance causing harm and what was employed doing just before
the incident occurred. If these fields are left blank

[1:39:10]
or updated as none unknown, nothing or similar verbiage, the field should be updated within
A, instead, I'm sorry, within A instead, and a missing 301 cent. Similar verbiage examples
would be unknown what happened, nothing happened, no object, et cetera. If you can remove
just the word unknown And the message still makes sense. It is okay to remove.

[1:39:39]
Example. What was an employee doing just before the incident occurred? Unknown lifting
technique injured employee. Remove unknown and leave lifting technique injured employee.

[1:39:52]
Example two. Describe the object or substance that directly harm the employee. Unknown
substance. and none can be removed, leaving substance as the object that enters the
employee.

[1:40:05]
The other 301 fields often has additional details regarding the employee's injury, and we
can sometimes use these fields to update our missing 301s.

[1:40:16]
If you update per other 301 fields, make sure to update exactly per what the field says, do
not remove or adjust wording. important copy, paste, do not select what you want from there.
You got to update exactly what it says. When not to remove management updates in 301s. When
not to remove it. So in the IMBPT, if this build has terms like applicant attorney, attorney
filed, CP, C11, CT, C3 blind app. these terms can and should remain in the 301s until we
receive a diagnosis. So these claims are blind apps and have a different process. If the
diagnosis on

[1:41:04]
medical does not list the body part or how it was impacted do not update this field. So
here's some examples of diagnosis we have already confirmed should not be added in the
IMVPT. In VA encounter of removal sutures, initial encounters, subsequent encounter, fall or
any diagnosis with fall in it, assault, chemical exposure, exposure to them. Okay, we know
these. Okay. If one of these diagnosis is the only diagnosis on medical CCN or risk
management notes will leave the INBPT as management has inputted it. Let's see if there is
no diagnosis or diagnosis codes on the claim do not update the IMBPT.

[1:41:56]
Body part injured, scene four impressions assessment, etc. should only be added if there
are, if they are accompanied by a diagnosis code. So suspected diagnosis or differential
diagnosis, Secondary or tertiary. I think that's how you say that diagnosis should never be
used even with diagnosis codes. Even if these have a diagnosis code, we don't want to use
those. Management updated in 301s when not to remove management updates. And so object
substance causing harm and what was the employee doing this before the incident occurred. If
these fields are not left blank unknown, nothing or similar garbage, these bills should not
be updated.

[1:42:49]
And so we don't want to wait. when we remove the marshmallow

[1:42:57]
Oh, okay, okay, okay, I got it now. Okay. All right. So then we have this here. When should
we update the IBPT and other 301 select all that apply and put your choices in the chat. So
they have these and then we have the the answers. I just keep the answers on a hidden slide.
And I see. Yeah, okay. So. So the next slide has the answers, but I have that hidden. So
that way, you know, of course they can't see it. I'll go. Um, let's see here.

[1:44:00]
All right.

[1:44:08]
All right, so then we'll go into the blind application process. I will tell you because I
think this is something that we've seen. Well, probably too many times and I know the
question has been asked you know a few times. One thing I would make sure to stress to them
is we only are going by when it comes to blind apps, we only set the task once. They don't,
don't set it twice. We said it one time, that's it.

[1:44:41]
And then I definitely try to explain to them like the only reason that we only said it if
there's no medical information on the claim. Nine times at a 10, we're not gonna have
medical information already on a blind application. So we need to, we're just giving it
time. So that's just how I tried to explain it. We're giving it time because these claims
are usually under some kind of litigation or some kind of legal issue process. And once it
starts going into like the legal things, then that takes more time for us to get
information.

[1:45:18]
And also, usually if an employee has an attorney, management can't, they can't contact the
employee. They can't talk to them about the claim. They can't ask them for any information.
So everything just gets behind also a lot of times with the blind apps, they are old. Like
you'll notice, like, usually they're not like a new injury date, they're usually pretty old.
So, so there's more information that's being gathered and things like that. So when we see
these blind abs, we give them time for information to come in and become available. So
that's why we set this task.

[1:46:04]
However, if we're lucky and there's already medical information on the claim with the
healthcare provider that we can reach out to, then we'll go ahead and just work it like
normal. We won't set the blind up task. But once it comes due, then another thing to stress
to them is when these tasks come due, we just work it like normal after that. So you just
follow the new processing new claims, and that's that's it. I mean, blind apps are pretty
simple minus not getting much information from them, but for some reason they struggle a
little bit with that.

[1:46:56]
Any questions on this one? No, I'm laying up. It's getting difficult when they respond,
maybe, but not that. OK, all right. No, no, no, no, no more question about the blame app. No
more, OK, all right. And even after this, of course, if you have questions, you can always
ask me, yeah. So, you know, we're not limited to just just what we're reviewing through
these sessions, but yeah, anytime you have any questions or anything, especially like you
can, you know, about training and things like that, or if you're kind of reviewing through
any of the training material.

[1:47:56]
And you have questions or suggestions, you know, then feel free to reach out about it.

[1:48:03]
Um, you were sent up from the uh, uh, all right. So, um, couldn't hear any claims. Um,

[1:48:14]
we see those. I don't remember. Uh-huh. Yeah. We still do this. But they are. Oh, you know,
what? I think I, I think they have new medical. Yeah. I saw a new medical. They do. Um, Um,
I saved one of these, um, oh, why are there so much, I saved it on here.

[1:48:42]
So I was like, oh, they have a new.

[1:48:49]
Well, well, well, uh, here it is. Okay. I said not hti anymore. I mean, so if you say hti by
the down like order provided, I don't know, it's kind of weird. Yeah, it is for sure. So,
like, let's pull it up over here. Oh, that one. Yeah. You can see there's HTI. But they are
like all three different. So I don't know. Yeah. So this is going to be the one, you know,
that they'll probably see, but. But we will still. You should say medical information on
everything.

[1:49:35]
I think so. So we'll still label it as HTI. Like this says. Like the same address. Yeah, the
address is the same. Now, if the address happens to be just. If there's medical attach, then
we should use that one. But if not them, they should be the same address. But yeah, so with
the annual hearing test, The main thing that I would make sure to tell them on this one is
that we do not send any escalation so make sure like they know like hey if there's a
breaking calendar, don't send it, you know, don't send any

[1:50:22]
indicators. Yeah, we don't send any escalations on these. We're just making it make sure
that it's coded as TBS. Yes, we are updating the the medical section, you know, and we're
I'm putting out the medical record for this game maintaining by age, okay, yeah, yeah, and
then I think this thing, I just get difficult when employees sick are not provided for the
hearing loss for the hearing test. So they should not so if it's not the annual hearing test
so like it so there's a difference between when they have just a hearing test.

[1:51:07]
And it's not the end and then when they have an annual hearing test so they always have like
their yearly annual. Same the same thing they're yearly hearing tests right so which would
fall under this like they go this every year. But then there are some cases when they go and
get hearing exams on their own and it's not part of the annual hearing test and that's when
we see those other providers. So, if it's not the annual one under like the HTI folks, yeah,
absolutely.

[1:51:49]
I think that happens once to me when it was a major. Yeah, I had one. I had one where I was
going back and forth with some of the installations. Yeah, because they did not want the
claim coded as an ocean one because they didn't do their annual hearing test or something.
They went to their own provider or a different provider. But I'm like, well, sorry, like
they said that, you know, they had a difference in their loss of hearing or something, and
that's automatically going to be TVFA.

[1:52:29]
too bad, so sad. But the annual hearing test, and the only time we get these is if there was
a difference in their hearing. So even though if they go to annual hearing test, if there's
not a difference, we don't see these claims, they only come over if there's like a decrease
in their hearing from the previous time that they had their hearing test. So, so that's why
we automatically code it as TBA, make sure that it's a TBA, yes, because hearing loss is
going to be TBA.

[1:53:17]
Okay. Any questions with the hearing claims? No. Okay. See, okay, we're doing good. Good,
I'll go to a pharmaceutical process.

[1:53:41]
Oh, excuse me. All right. Let's see here. Okay. Yeah. I think a little time on this one. I
don't know exactly if the next class is going to be done the same way where it's going to be
a long time before they get calls and things like that. So, depending on how that goes,
we'll depend on if they even remember this because, you know, if you're not doing it, you
kind of lose it. So, but with the calls, it's going to be important that they know, and I
still sometimes I'll even see Mike more season reps.

[1:54:25]
This was months ago when there was that issue with what they have to do as far as when they
get a phone call and it really all falls back on were any updates needed on the claim. So
that's going to depend and also is it a claim for someone that's no longer here. So, first
rule of thumb is, no matter what the call is about, there should be a note about the call.
Even if you don't make any updates, even if it was just a silly, simple question, there
should always be a note in the claim about the phone call, the bound call.

[1:55:05]
And then, if they make updates to the claim, then they need to set a task for the claim
owner. they do not have to work the whole claim. They should review it as much as they can.
They don't have to review the whole claim, but I mean they definitely want to try to make
sure they're reviewing enough for what updates aren't needed. So like if they if the call
was to satisfy an RHPD. So they call and give us the information. So they need to make sure
that it is

[1:55:44]
the correct information that we were looking for, you know, like if it was

[1:55:50]
R.H.P.D. for ER, you know, pay attention, like is management giving us actual ER

[1:55:57]
information, or are they giving us information for concentra? You know, and if they are, you
know, they need to, you know, make sure to ask like what about an emergency room did they
go, you know, and document that information. It needs to be a very good their own note and
always get the callback number. That's going to be important because if they're leaving, if
they're gathering information, making updates, then they should always be leaving a callback
number or the claim owner in case, you know, if you're like on a call with someone and
you're trying

[1:56:33]
to get the information, you know, you're kind of feeling slightly rushed and there's a
chance that you might miss something or maybe you know it just was not the information that
the claim owner was looking for so this gives an opportunity to call them back or maybe
there was a conflict with the information that was given. Yeah so maybe it um you know there
was a conflict with the TWA or lost time date so just um that they always get a callback
number from the person and

[1:57:07]
and making sure and do not use the callback number provided from intake. They need to ask.

[1:57:19]
Yeah, they need to ask for the phone number.

[1:57:25]
One thing that I did go over with the last,

[1:57:31]
well, not the initial ICM training, but when we train on the, for them to move on, one thing
I did address was phone number format.

[1:57:46]
It should always be the three numbers, dash, three numbers, dash for numbers

[1:57:54]
because I see a lot of times it's one long phone number. So it should always be like this
like this in the chat versus that. So yeah, because one thing is, one time it was given to
me like that second example. I had to call like a management person back and it was missing
a number. So one thing, it's going to be harder to recognize that when it's all together
like that and that's just, you know, the format that we would be used to say in as the three
numbers, three numbers, four numbers,

[1:58:45]
or phone numbers with the dashes in between. Um, and also, um, any notation, you know,
anything like that because that's how we're used to seeing numbers. We'd want to have it
like that as well. Um, because another place I saw that was when, um, we escalated to health
and safety about an employee who needed a claim enter. There was a no claim. They sent them
the phone number and that second format I sent and I'm like, that's not a recognize that
doesn't. We would recognize a phone number with the dashes versus

[1:59:27]
the other way. That makes sense. So I just want to make sure that when we're putting phone
numbers then have them in that format. The other thing, what was it? And then also making
sure that they know what type of updates are considered urgent requests. So urgent requests
say it must be performed or immediately based on the college request. So like closing out
escalated requests and calls that are gonna start or in absence records. Those are going to
be the things where that falls under updates made or follow up required.

[2:00:18]
And they need to make sure that they're setting a task for the claim owner to give back into
the claim. And because basically they just need to check and make sure that the information
that was updated is correct. and then, but if not, if it's not something where they need to
make an update, then they would follow these steps here, where no follow up is required. And
then it gives some examples down here for them.

[2:00:48]
All right. Any questions on this one? I think the only question I have in these areas is
about the complete review plan because the idea for me or the idea that I have in this area
is, for example, and I get the call from a client that is from Fabi. Fabi is still working
with us. I'll review what is the call, for example, management time to know how to answer
all the escalation, let's say to RSPD, so they give me the information everything, okay, I
work the task, I work everything, I document it in the notes, I'm slow the task and
everything,

[2:01:30]
and that's it, I leave a task, so the owner of the claim, continue to review the whole
claim. That would be a different situation, for example, I receive a call for the song, and
that is no part of, I mean, or didn't anymore. So in that case, I will need to take the
claim. I will do the full review. Yeah, okay. Right. Yeah. Okay. Okay. So I got different
grade information. Yes, sure, then. Right.

[2:02:02]
I'll keep the key, mental illness. All righty, mental illness claims. I think with this one,
I feel like I keep seeing claims where Um, reps are forgetting to, uh, especially with the
new group because it's usually, um, a new claim that came in and there, uh, there's no
coach, uh, stamp on it for mental illness claims, but, you know, the, the claim owner. The,
you know, has been here for a while so they know so then they ask for the the mental illness
coach stamp and is that kind of look I'm like, well, this claim has been worked before and
there's no coach, coach stamp.

[2:03:03]
So, I think they're kind of missing the consulting of coach and they're just working the
claim, the new claim. Even, so just kind of going over, making sure to go over those. We're
always fast. Oh, okay, oh, good. Yeah, like, and these are just a couple examples, you know,
but when they see these types of injuries, they should always be getting a coach stamp on
it.

[2:03:42]
So, because the first thing that says consult a coach prior to processing. Okay, so that's
the main thing I would stress on this one is make sure that they're getting the coach stamp
when they come across these claims, and can always do like mental illness claiming samples
that we can, you know, know, um, can always pull them from like the chats or whatever. Um,
and then just show them like the, um, INBPT, for example, like this. Okay. Like when you,
when you did that, you tried to find like each example for, like the three situation, or
just want to get a.

[2:04:31]
I think it's difficult to find one with a set that, but if we don't find, I mean, we we just
know here and explain a few examples.

[2:05:00]
We're doing more like normal, depending mental, depending on maybe sometimes the physical
with the mental.

[2:05:10]
Are you talking about like a new claim that hasn't been worked? I don't know, I mean, when
you say that you want to give it like a sample, like a claim, so I would think it may be one
for each situation, maybe if we had the change to found.

[2:05:25]
maybe. So my main thing is I want them to see what it looks like as far as the IMBPT for
mental illness claim because they miss those. They're not asking for a coach. So I want them
to see as soon as you see something like this or even looking in the injury details, sure
you get a code assistance. Now, if so you're saying as far as like the pending accepted or
the injury slash mental stress claim, have an example of that. Yes, I think that would be a
good

[2:06:09]
idea, especially with the injury slash mental because that probably more than making sure to
have this one and then the pending or accepted doesn't really matter either one of those but
yeah seeing the injury metal stress claim. And let's see here.

[2:06:40]
Yeah, okay

[2:06:46]
Anything else is they should just be, you know, is all of the

[2:06:51]
Follow the Irish steps that most importantly get a coach first before

[2:06:56]
Working it It's correct

[2:07:01]
All right, any questions on the mental illness?

[2:07:05]
No, no, no, no, I used to have like a really doubts with days But I think with the update
like separately the three-year scenario I think now is really clear All right, cool, cool,
cool, and voice location.

[2:07:28]
And, you know, um, I mentioned sometimes like when you're training, you have to like adjust
to a situation. So, um, one situation that may come up is like, um, you know how when we
were working when on my tinerary where it says to work the ocean one through four. Oops.
see? Oh, show one through four claims. You might run into an iris that you have not reviewed
yet.

[2:08:03]
So that's okay if that happens. Like, for example, maybe you at you, you're working on these
and then, I don't know, you need to use the invoice locations or something. That's okay to
then jump to that iris and then look at that. But for the most part, you probably won't need
any of these.

[2:08:33]
Because you can easily check if a claim is like a blind up hearing or mental illness.

[2:08:41]
But just so you know if there's something like that where you run into that you can just
jump to to that iris and be like, okay, well, we haven't come across this yet. You know,
let's go ahead and review that because that has happened before. All right. Which one. In
voice locations and I pull that up. Okay. This one is, you know, this is more like import,
for example, if they receive an import call maybe, but yeah, nothing they've only used it
like a lot. No, they won't.

[2:09:28]
Yeah, they won't use it too often, but if they do, then we'll just show them how to use it
by looking, you know, at the States. Um, most often, you know, of course, we use liberty
mutual, but then going over the other states to, um, so that one's pretty easy.

[2:09:55]
Let's see here. Okay, transaction history.

[2:10:09]
So, I'm trying to think of anything that really stands out.

[2:10:30]
Okay, so I'm trying to think of anything that seems as far as questions that they typically
might ask or something like that when it comes to the transactions, nothing is coming to my
mind right now. And that's pretty irisal, you know, explain everything in here for them.

[2:11:06]
Yeah, I mean, I think it's pretty clear. What indicator we use, what like a code or a
number, whatever. Yeah, I mean, it's pretty specific to what we use. Yeah. Yeah. One thing,
Oh, so I would tell them. And this is the difference. You know, yes, really make sure like
hey. Reserves, you know, we do not use this for anything we do down here. It has to be an
actual payment and that goes for like when you see this in CC. And also reserves, we don't
worry about this.

[2:11:43]
I'm putting money aside. So, um, so yeah, so just that and next, oh yay!

[2:11:58]
Oh my god, the ocean. Yeah. Oh, God, I love this. To be honest, I never see a way that word
is this claim correctly. I never see a way that really word is claim correctly. We always
know that they miss on information. I don't know why. I don't know why either. I, um, yeah.
Like these claims have just become a nightmare. So, um. So yeah, so, so we're very familiar
with, um, this one. With, um, or zero with more than $500 medicals. I remember does this
explain I mean this is basically just to look the hot look for the hot

[2:12:58]
claim to try to find something to update the old shackle I mean because if more than 500
payment in America the claim will be a lease of your own yeah usually sometimes yeah but um
so here the thing that I've been seeing a lot is a lot of these things that are coming
through as medical payments a lot of times are like like attorney type fees and stuff like
that and it's not really medical treatment and a couple of them have been real OSHA zeros
meaning like all the treatment they

[2:13:43]
had was not treatment beyond first aid. And it was still over $500. So we do have some that
are like that. But yeah, so we did. I would just let them know the idea is if that typically
if an employee had more than $500 worth of medical bills paid then there's a good chance
that there is treatment beyond first aid and that's what we need to look for. Oh also I
noticed that they weren't they weren't doing anything else in the claim like they weren't
working the other things in the claim they were just

[2:14:34]
Just reviewing that this part and ignoring anything else. So there's that and also when they
are finding treatment, they are not doing things like updating the medical section or
something, you know, they keep it pretty limited to just this, that's it, and then they're
out of the claim. And that's not really what we want them to do. So, yes, we want them
checking for all the, you know, the indemnity and the medical information, but but that
doesn't mean that we just stop there.

[2:15:30]
Okay. Yeah, so if there's other things on the claim that we find such as like breaking
counters or LTIs or TWA indicators, anything like that, then yeah, we need to make sure that
we are updating the claim and, you know, just like normal. And we found that information
wasn't escalated at the beginning, so we need to do it.

[2:16:00]
Exactly. Yeah. Most of these were just like no treatment type claims. Or maybe there was
treatment at first that was under $500 and they started treating again later. So yeah. But
those would be the two things that I would really go over with them to make sure that they
understand that.

[2:16:25]
All right. Okay.

[2:16:32]
The coyote and marking claims you don't really get any more. So I still review this. I mean,
we can leave it there, but just in case it happens. I think it's just that we're not getting
any new ones, but there's. I see a lot of ones. So, so we still just I just go over this
little bit of information here with them for the coyote and marketing claims. And then I
always just show them an example of one of each of those

[2:17:17]
a coyote and a American. I think we have a like widget for those. Yeah, yeah. So I usually
just pull one from that widget and just kind of show them the difference and you know how to
tell if it's a coyote remark and claim and I think we yeah we went over this one for intake
so you know the emails received and then COVID claims we went over this one but we just went
over the intake part Yeah, the part of the IGN, we didn't see.

[2:17:58]
Yeah. See? What? Okay, well, it was pretty good.

[2:18:07]
All right, so come down here. So the only time they would ever get these creams is one, we
don't really get new ones, but if we, if region or ICM gets one, it's because and take us
already did like the initial reviewing of it and and Liberty did accept it. So that is when
now it is with an ICM. So COVID positive claims will be moved from intake to ICM once it is
deemed to be work-related and accepted by the carrier. So ICM would review the carrier notes

[2:18:47]
for informational regarding absence record and coding. So things to consider, the likelihood
of having medical documentation to support the claim is going to be slim. So if the carrier
changes the termination to not work related, it should be now graded to O-sh-0.

[2:19:04]
Determine if the employee missed works. So if the employee continues to work remotely from
home, lost time will not be recorded. I'm gonna start lost time and follow IRIS-236-4-6.

[2:19:16]
I mean, not really, because that's mostly from medical. from medical, so if the employee in
this work look for a return to work date, if the criteria does not provide a return to work
date from last time, work day can be utilized to end the absence record.

[2:19:37]
Again, that Iris article is not gonna help with that. So, I guess, I don't really want to
teach them how to look I don't really want to teach them how to look through work days to
find the end date because let's see, let's information. Yeah, like we can, a coach can just
check that. And plus they're not going to come across this too often, so they'll, they'll
forget by that time anyways. Documents exactly where all the information was identified and
your notes and you're going to close all open tasks.

[2:20:15]
If the employee is yet to return to work, set an employee services absence record check
through of UCCN for new information and set it for two weeks. So basically, all you're doing
is looking through CCN, seeing any notation where mentions the employee was out of work. And
then if it gives a date, like if maybe I'm learning mutual how to note on there that said
that employee has not been back to work since the date of or stop working as of the date of
injury and then they returned yesterday on, you know, whatever and they put the date.

[2:21:03]
So that's our app. So we would put lost time in for the start date. That was document and
their note. And then we would end it based on the CCN note. And, and then that's it. So. So
the claims we use carrier notes to update the absence record. No medical required at all.
all right like we haven't really worked one of those in years really yeah um

[2:21:44]
they used to be quite common claims glad they're not anymore okay last the last quickly that
I see is and we just started to be a coach and I have one of then and I just asked one
people to to work that degree was like the expert on intake at that moment.

[2:22:06]
Yeah. I wonder what was the last quickly that I see.

[2:22:12]
I just I'm almost like and I actually think last the last couple classes I didn't review
that Iris. Just one because we were kind of like, I didn't want to add that to, I didn't
want to add that because one we were kind of like getting, you know, backed up on time. So,
also, I'm just like, man, we don't even work COVID claims. So, I just said if you get a
COVID claim, ask for assistance because one, they're not going to remember how to work it.

[2:22:56]
And two, they can review iris if they have questions, they can ask. So, I mean, it just
wasn't worth the time to review that iris and try to shove information in their heads that,
you know, You know, it's just they're not going to remember and they don't really need it.
There's already so much to do. Yeah. Okay. So then we have our final quiz. This one. I'm
pretty sure there's some updates that I still want to do on it. Let's take a look. All
right. So this one should cover just about everything.

[2:23:43]
And again, if you have questions that you want to add or any suggestions. Yeah, you feel
free. Feel free to bring that up. Who enters the initial details for an injurer on this
claim in G. that's going to be an employee supervisor. Any true or false if medical
treatment thought is listed as unknown and the employee's claim is coded as a three, we
should not update medical treatment thought to yes. All. Super false. All right, true or
false? The injured employee is given permanent restrictions by the health care provider.

[2:24:25]
Has completed the ADA process and placed in a new position in UPS. and UPS. Management can
return the employee to work without any further medical documentation as long as they
provide the ADA agreement form. To be true, um...

[2:24:48]
I just want to make an update.

[2:25:06]
Yeah, all right. I wanted to add the return to work date because we need that. All right,
two or false. If our in all notes section notes are required to document all actions that
are taken on the claim, even if follow up is not required. That's true. Which functions in
the right panel display items that require action or follow up. Generally apparently it's
play.

[2:25:41]
Okay, oh, there. Did you show me this place?

[2:25:50]
So, all right, sometimes when you come back to things you notice like, okay, I need to add a
little extra word there. All right, complete the sentence. Entry ICM advisor. Work claims
filed through. Okay, that should be easy for compensation to or false. The name of the
dashboard that advises work from is called the Employee Services CCR dashboard and main.
Very true. Where do you view a list of all assigned claims with tasks due today?

[2:26:30]
Dashboard widgets. What do you look for? I was thinking of CCR all tasks. the CCR AllTask.
Oh, okay, gotcha. Yeah, Jeff. Yeah. Cool B2, I mean. Well, the CCR AllTask will have past
present. All the tasks under your name. So, so this one, let's see, a list of all assigned
claims with past due today. Well, I mean, I mean, but no, I mean, that was

[2:27:21]
Okay. Okay, let me stop thinking about it. Okay. Why do you look for in the dates listed in
the last date section of the claim? What do you look for in the dates listed in the last
date section of the claim that date of injure illness? If there are any gaps for them one
day between dates. If the EE is across the night worker. All right. Okay. Yeah. Okay. Which
OSHA code indicates that only first aid treatment was provided? Okay. Complete the sentence.
A request duty status is a request for clarification of lost time or TWA sent by email
template to

[2:28:10]
The management team, I want to add some things.

[2:28:21]
And

[2:28:27]
Yeah, I was thinking you're going to put like a, a cascalita, oh man, hold on,

[2:28:39]
I heard that word yesterday and I forgot, it was yesterday, I don't, you really forget it,
oh my

[2:28:47]
I'm old Jonathan, okay, my memory is not what it is,

[2:28:54]
All right, no, tell me again, what does that mean?

[2:28:57]
No, like the peel of the banana, something like a little trap. Okay, yes, yes, yes, yes,
yes. Okay, okay. And say it again, cascarita. Cascarita. Yeah. Perfect. Okay. All right. I'm
going to do my best to remember that. Okay. On the injury claim, which one of these sections
display the OSHA code? should regulatory required information section? To your false, if an
advisor does not make any updates to a claim, he or she closes the edit claim window by
clicking cancel. True.

[2:29:42]
All right, which section of the claim will only display if the section has content? I'm
going to be the claim absences and the medical information. How do you select a link to open
it in a tab? Right click. What are some common steps in the RHPD and RDS escalations
process? Select all that apply. Okay, so we're looking for sending emails and creating
follow-up tasks. creating new content, contact, or editing claims, where you need to go to
view a list of tasks that are due or overdue. The dashboard. Let's kind of like the other
question a little bit.

[2:30:35]
From an open task, which option do you select before escalating the task? What steps do you
take if the injured employee has more than one act of claim? Unfortunately you're going to
consult a coach. Hey, yeah. What is your last step in reviewing the claim? Create an
employee services claim review note. When a data service for a medical visit is not
received, how do you first attempt to contact the medical provider in an arm escalation? By
that's or by phone, either one.

[2:31:23]
What steps do you take before you update any claim information and click edit and review all
information on the claim.

[2:31:33]
Open this or explain this. When you update these sections of the claim, G-Sharmas will
automatically change the claims of Oshakode. Thank you. Thank you very much. I mean, I had
joking with me. Oh my god, no. But some regulatory inflame absences. Where do you look for a
change request that has been assigned to you? The dashboard. That's the answer to so many
questions. Oh, look.

[2:32:14]
Did you made it? Someone say you're emitting that look? I wonder if someone is answer that.
Answer like that. I don't know. Which of the following types of change requests do not
require medical documentation, but do require detailed information to support the change in
the claim?

[2:32:35]
Treatment beyond first aid. All documents attached in a change request will appear in file
section of the change request. True. And true or false after reviewing a medical document,
you must update the file description. Also true. Please do that. Please. I hate reviewing
claims that don't have those updated. Um, Iris Resource 261-9, Reviewing Medical
Documentation, provides details on which of the following. It's going to be all the above
with providing instructions on how to deal with discrepancies between timestamps, can
appointment, it contains links to each of the related Iris resources

[2:33:35]
mentioned in this module. The resource provides details about how to compare and capture
information on the claim. provides information on how to escalate requests for further
information or clarification when information does not match on the goodness. Where does the
intake group attach the medical documentation for a claim? A file section. Okay. In addition
to Iris, which other software tools might be used to obtain information to update a claim
from medical documentation. I see the code in Google,

[2:34:24]
even though Instagram would be good. What information do you verify to ensure medical
documentation belongs in an employee's claim? In your description and your body part
employee's name, date of injury. What three steps do you take to review a medical document
attached to a claim? Validate the document assigned, captured document information of the
claim and update the file description. And then why is 917 25 and employee treats at the ER
on 917 and instructed not to return to work until 923? then fully also treats with concentra
on 917 and given restrictions to start the same day.

[2:35:11]
Would this be considered contemporaneous medical or conflicting work status medical?

[2:35:16]
And 10th or right? Yes.

[2:35:23]
Don is like I'm not picking the right answer. can't always make an absence record coding
more severe than medical. However, they cannot make it less severe false. Oh, I was really
really really read that backwards. I mean, I really like less severe about Leo. Okay. I
would think like backwards. Sorry. No worries. Data of injury is 711. Employee treats that
concentron 712 mid shift and is given restricted duty. Management submits a change request
to start TW on 714. What day should we start TW? 713. 713.

[2:36:18]
13 is going to be the day and true or false employee is currently on lost time and we just
received the medical from their last office visit and the health provider says the employee
can now return to work with restrictions. This is enough information for us to transition
the employee from lost time to TAW. False. And then we would explain management has to
confirm. So, with this one, I'm thinking this might be a little too tricky. The employee is
currently on Los Angeles. And we just see the medical from the class of the BZN,

[2:36:59]
the enterprise in Sydney. We can narrow it up with restriction. This is an advantage. No,
no, no, me. Is it okay? I mean, there's a way of talking about about the transition from Los
Angeles to TW. True. Um, but I don't want them. Well, the question, the question is
basically saying that he only has the make out with a decision about doesn't have the
management confirmation. Yeah, and that's what I was thinking about, um, to have a very, to
have all the facts. Um, also, maybe like, like adding something in the question.

[2:37:40]
Yeah, like no correspondence received from management. We're like adding here, like maybe we
have not received any correspondence from management. However, this is enough information
for us to transition. Well, I don't want to lead them to the answer though. I don't even
like that, or what? I'll just leave it for now. All right, which words cannot be added to
the IMBP team? That is post surgery, chemical exposure, initial encounter. And, oh, you know
what? I want to add, I want to add unknown, um, what's, uh, something with the, with the
update of the ideas.

[2:38:40]
Like, for example, like, like the chronicle.

[2:38:45]
It's when the, um, diagnosis has the word unknown. Oh, okay, okay, okay. What's one of the
ones we typically see unknown? Okay, you need hand unknown maybe. Say that again. You need
hand a comment unknown. Does it have a real genital? Um, I notice this one. Let me see
something real quick.

[2:40:02]
Okay, you know what?

[2:40:06]
I'm

[2:40:16]
Or maybe it's usually says unspecified. I don't know.

[2:40:27]
Okay, I'll have to come back to that one sometime I can't think of

[2:40:55]
Okay, I'll just come back to that one. Remember two. Okay, if the employee. If what was the
employee doing just before the incident occurred and described the object or substance that
directly harm the employee has none unknown is blank or has similar verbiage, what can we
use update the section? replace the information in A, replace the information from the other
through one field if it has information regarding the incident.

[2:41:29]
When are manual updates required in workday, when zeroing out a lost time sequence,
lengthening or shortening lost time sequence, and reopening a lost time sequence.

[2:41:41]
If the timestamp on the medical document does not have AM or PM next to it, what step should
you take? Go to the provider and check their hours of operation.

[2:41:55]
Or ask the coach to choose one for you. Yeah, please don't do that true or false, if a claim
currently has no absence record, the medical documentation provides work restrictions, we
should wait to start to until we receive confirmation from the injured employees management.
Very false. I feel like new reps tended to do that at first. Like they wait for. Yeah,
because they're like a like a frame to. Yeah, sequence. Yeah. And true or false, if the
injured employee declines the TWA offered by management, we should move them to last time.

[2:42:40]
False as well. which are rules for starting an absence record. Select all that apply.
Supporting medical documentation is not required prior to starting an absence record. We
should always check the time stamp on medical and the employee shift start time. Also, we
can use verbal confirmation from the provider. Oh, one more thing, like when we're reviewing
absence records, one thing that I tell them is if you're looking at a medical with the data
service that is also the date of injury, do not worry about that time stamp.

[2:43:26]
because it doesn't matter if it's pre-shift or it shouldn't be pre-shift, but it doesn't
matter if it's mid-shift or post-shift. You know, so whatever the work status is is going to
be for the next day. Because we drill in to check that timestamp, but if it's if the data
service is on the date of injury, don't worry about that timestamp. Okay, yes, that is.
Yeah, I got like all it is appreciate or whatever. I mean, we went to sign the next day.
Yeah, so that just will save them a little time.

[2:44:10]
which are rules for ending an absence record. It's going to be regular duty medicals
required. However, there are a few exceptions. We can end the absence record for employees
whose status reflects terminated. An absence sequence cannot be ended prior to the day
specified on the medical. Okay. So next one. Please review the image based on the breaking
counter response. Employee was given restrictions on. January 23rd, and the change request,
um, uh, why is that sense like that, huh? Review the image. Okay, so we have to different
start the breaking calendar and chair request.

[2:44:58]
So here's the response, he was given restrictions on 123. So that's the change request
response. Okay, so it's just this quoting it up here. Okay, cool. And in the change request,
what steps do we take? Oh, oh, okay, I got it now. For some reason when I was reading it, it
was not making sense, but I, I, I get it. Okay, so they're giving us come like conflicting.
Yeah, okay, cool, and then the answer is deny the change request and start TWA on 123. Okay,
so yeah, all right, wonderful looks good to me.

[2:45:43]
When can we not end the absence record per future data medical, and that is when there is a
visit scheduled on before the return to work date. What part of the claim should you review
every time you first enter or re-insure a claim? A lot. Yeah, Google. All notes, all files
and tasks, change requests, claim absences. All emails and transactions, history, through
ones and HCP section. All right, true or false, it is not required to update the IMBPT per
CCN or risk management notes when the medical document provides a valid diagnosis.

[2:46:29]
That is true. And which diagnosis should not be added to the IMBPT? It's like all that
apply, should not add MBA exposure to hazardous chemicals, specified fall initial encounter
and overexertion from repetitive movements. All right, and that is the end. 51 questions and
um so um honestly last class we did not get to play the Jeopardy game. We just we just did
not have time for it. And that was like the first class that that we didn't do that but
because typically what I would do and I really think with so many additions that have been
added to Iris and just to have enough time that because it was two weeks that we would do
training

[2:47:32]
But I really think it needs to be a little bit more than that, but we would do a jeopardy
game on Friday, the first Friday and then a jeopardy game on the last Friday. So that,
again, that's one of those things where like as a trainer, you got to kind of figure out
like, do we have time to do this, you know, and last time was like, no, we don't have time.
so we did not get to do the the jeopardy game. And then, so just remember at the beginning
of the day,

[2:48:12]
we just do a recap. And that's just kind of going over, you know, all the things that we
went over the previous day. And that's usually like, say, man, we'd do that with the slides.
And just do like a morning recap before we started our next lesson. Oh, yeah, remember that
better. Yep, so that's it. That's all the ICM training. Just walk through like typically how
the whole training schedule goes. And do you have any questions?

[2:49:00]
Can we start over? Sure, let's do it. No, we're just kidding. No, I mean, no. I mean, so
far, no. I maybe, maybe at the moment, when I have training to do that, or was it really
like, I was trying to make a note for me to do that. Maybe I would have a few questions. I
know I can kind of ask you. you ask you and I just want to say thank you for this week and
the last week for all the time you put together to review everything with me. Yeah, no, it's
no problem. So the way that it's been

[2:49:33]
explaining is that you know like when the next training class you will be able to I think
you'll be able to observe. So you won't have to just like frame the whole class or anything
like that. So

[2:49:56]
it's supposed to be like a slow transition.

[2:50:02]
I hope so, yes. All right, cool, cool, cool. All right, so yeah, so then we're good. I don't
have anything else but you know we can definitely keep in touch on it like if there's
anything that um you know I am when I you know just give you a heads up on or you know
something like that or if you have any questions I mean can we can yeah I'm definitely
communicating. Oh sure Oh, thank you. No problem. He's everything.

[2:50:37]
Okay, doke. All right, Fabian, did you have anything to add?

[2:50:44]
No, not at this time, Rochana. Thank you so much for your time and your help as well, Lisa.

[2:50:51]
All right, guys. Well, I guess back to coaching. Thank you. Thank you. You're welcome. Bye.
Bye. Bye. Bye. Thanks. Bye.