EK Perspectives Newsletter


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Getting the Most Out of Your Case Management Program

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Published on: Thursday, March 16, 2017

One of the most effective tools for assisting your workers’ compensation claims team continues to be intervention by a Nurse Case Manager. Nurses assigned, on targeted cases, can be instrumental in cost containment. They serve as an advocate for the injured worker, assist in ensuring optimal care, and decrease disability days. Strong, healthy, case management programs that bring value require work on the front end to…


UR/BR Connectivity and Effectiveness

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Published on: Thursday, January 26, 2017

  Utilization Review (UR) and Bill Review (BR) are two key components in the managed care industry that must work together effectively if a program is truly going to flourish. For years so many organizations struggle connecting these two areas effectively. Have you had situations before in the industry where a service or procedure was denied from the UR department but for some reason the bill still ended up being paid…


How SB 1160 Impacts Utilization Review

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Published on: Monday, January 23, 2017

Governor Jerry Brown Signed Senate Bill 1160, which primarily affects Utilization Review (UR) and liens. Changes will become effective on or after January 1, 2018. Medical treatment for injured workers may bypass formal UR for the initial 30 days of a claim with emergency treatment services, treatment related to an accepted body part(s), treatment rendered by a physician within the claims administrator’s Medical Provider…


MSA and the Joys of Conditional Payments

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Published on: Monday, January 16, 2017

  As part and parcel of the overall MSA process there is an item called Conditional Payments. When the Medicare Secondary Payer Act went into effect 1980, there was language in the Act which provided repayment to Medicare anytime a payment was made for treatment relating to an injury where another party was responsible. The idea being that any time there’s a work comp claim, a liability claim, or a group health policy…


EK Health Newsletter - Q2 2016

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Published on: Friday, July 8, 2016

        JUNE 2016     EK Health Featured in Forbes Magazine     Eunhee Kim is a home health nurse who built two companies that are transforming managed care in the workers' compensation industry. Now she's turning up on the pages of Forbes…


EK Turnaround Time Results

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Published on: Monday, November 16, 2015

  We don't just promise it, we deliver! Bill Review Turnaround   While every jurisdiction has aggressive turnaround time standards, when measuring against the most strict turn -around time standard of 15 days for California electronic bills, EK Health's results definitely exceed expectations.Being able to deliver turn around times at least 2x faster has allowed…


Reflecting on a Successful 2014

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Published on: Monday, January 26, 2015

A new year can bring a number of changes that may challenges us, but it also provides us with new opportunities for growth and success. Even though we are already hard at work in 2015, we want to take this opportunity to share with you our achievements, future goals and our appreciation as we reflect on a successful 2014.At EK Health, everything that we do as a company is guided by our Vision, Mission and Values. The…


In Utilization Review, Timing is Everything

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Published on: Monday, January 19, 2015

With the enactment of the SB 863 Independent Medical Review (IMR) process, the legislature wanted to have medical determinations made by medical professionals and not workers' compensation judges or the litigation process. The challenge has been to make this paradigm shift smoothly so that injured workers receive quality reasonable and necessary medical care based on the MTUS guidelines.On October 6, 2014 the WCAB en…


Physician-Dispensed Medication in Workers’ Compensation

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Published on: Friday, September 26, 2014

by Douglas Benner, M.D.Chief Medical Officer, EK Health Services, Inc.   An interesting article in the May 2014 JOEM highlights a still significant issue in workers’ compensation: dispensing of medication out of physician offices. The results confirmed similar findings in a study in CA by CWCI in 2013. This Illinois study1 reviewed 6,824 comp claims with Accident Fund of Illinois for the years 2007 to 2012. When physicians…


Always Provide Justifications for Medical Treatment Requests

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Published on: Monday, September 22, 2014

by Douglas Benner, M.D.Chief Medical Officer, EK Health Services, Inc.   Reminder: When making medical treatment requests, it is essential to explain WHY a particular treatment is requested. This will help the Claims Administrator approve the request at their level, or facilitate approval by a UR organization if the request is elevated to them for review. For medications, it is useful to document the indication or…


Education - Sharing Knowledge to Achieve More

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Published on: Monday, July 21, 2014

by Eunhee Kim RN MSNCEO, EK Health Services, Inc. Our Workers compensation industry is seeing experienced well-seasoned nurses and claims adjusters leaving their positions either through retirement and relocation. Sadly, there has been not a lot of sustained effort and investment in educating and encouraging the new generation workforce to our industry. In workers’ compensation where the environment is always evolving,…


One of the First in California: EK Health Select MPN

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Published on: Monday, June 2, 2014

by Steve KlineGeneral Counsel, EK Health Services, Inc. On May 21, 2014, the DWC approved the EK Health Services, Inc. application for the EK Health Select MPN. Prior to the passage of SB 863, only insurance companies and employers could create a Medical Provider Network in California. With the 2012 reform legislation, entities that provide network services became eligible to own and create an MPN. We are proud that…


Less Than 30 Days to Go

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Published on: Monday, June 10, 2013

by Steve Kline, Esq.Legal CounselEK Health Services®, Inc. Close to 95% of the California reform, SB 863, will go in to effect on July 1, 2013—less than 30 days away.  The remaining items, mainly concerning Medical Provider Networks, will become effective on January 1, 2014. In one area of the system, specifically, the Independent Medical Review (IMR), the community has had some experience since the beginning of the…


Does Office Work Promote Sedentary Lifestyles?

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Published on: Friday, October 12, 2012

by Gloria Farley, RN, BSN, COHN-S Ergonomic Service SupervisorEK Health Services®, Inc.  Does office work promote sedentary lifestyles? - It doesn't have to! The increasing rate of obesity in America is typically associate with our sedentary lifestyles—defined as not physically active.  Individuals sit, on average, for 14 hours and 39 minutes per day, mostly at work.  When not sitting, individuals are also considered…


Ergonomic Summer Gardening Tips

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Published on: Friday, June 15, 2012

With summer upon us, many of you may be hitting the garden with new fervor planting bright beautiful flowers, fruits & veggies. Here are some "ergonomic" tips to keep you "feeling" your best as you garden. Always use gloves and use a pad for your knees when kneeling Gloves provide padding and to prevent cuts and scrapes Gloves should be form-fitting—thin gloves are preferred; too much padding will decrease hand…