Revision : 2
Record Description : The Compensation Reviews are utilized by Team Leaders to review all compensation paid by Claims Service Specialists for accuracy and appropriateness; at the correct rate, for the correct period of time, the correct type, (LM, TT, WL), if POA’s were honored, if the mailing address is correct, etc. (LM) Living Maintenance Compensation, (TT) Temporary Total Compensation, (WL) Wage Loss Compensation and (POA) Power Of Attorney. The goal of the Compensation Review is to conduct an audit to ensure the CSS’s are carefully creating all indemnity plans, regardless of the amount or payment period and to determine if a red flag exist. The Claim Audits are utilized by Team Leaders is to validate CSS/DMC/CSA1/OP2/Nurse compliance with policy, procedure, and different guidelines that have been identified as required in order to achieve statewide consistency, accuracy, and quality. Results identify areas where additional focus may be needed at any level – statewide, within a few offices, a specific office or CSS/DMC/CSA1/OP2/Nurse.