A review of workers' compensation claims: the frequency of claim denial and medical treatment delay.

dc.contributor.author Kelley, C R
dc.contributor.author Amparo, J M
dc.date.accessioned 2016-10-25T23:17:53Z
dc.date.available 2016-10-25T23:17:53Z
dc.date.issued 2000-01
dc.description.abstract A retrospective chart review of 257 patients who presented between January to March 1998, was conducted to identify the frequency of workers' compensation claim denial among patients who reported to Straub Clinic and Hospital. Results showed that 12.8% of claims were either "denied" or temporarily "denied pending investigation". Analysis of all the claims found that only 2% resulted in delayed medical care. Further analysis of the denied claims revealed the vast majority of claims (78.8%) were denied because the medical provider and the patient had incorrect workers' compensation carrier information. Other independent variables studied (size of the employer, category of employer, injury type, status of case, length of case and number of visits) did not predict either denial of the claim or treatment delay. This study suggests that the efficiency of our State's Workers' Compensation system would be greatly improved by developing a system to provide medical care providers with accurate insurance information.
dc.identifier.issn 0017-8594
dc.identifier.pubmed 10740928
dc.identifier.uri http://hdl.handle.net/10524/53870
dc.language.iso eng
dc.subject.mesh Accidents, Occupational/economics/statistics & numerical data
dc.subject.mesh Hawaii/epidemiology
dc.subject.mesh Humans
dc.subject.mesh Insurance Claim Review
dc.subject.mesh Occupational Diseases/epidemiology/therapy
dc.subject.mesh Retrospective Studies
dc.subject.mesh Time Factors
dc.subject.mesh Workers' Compensation/economics/statistics & numerical data
dc.subject.mesh Wounds and Injuries/epidemiology/therapy
dc.title A review of workers' compensation claims: the frequency of claim denial and medical treatment delay.
dc.type Article
dc.type.dcmi Text
prism.number 1
prism.pagerange 11-3
prism.publicationname Hawaii Medical Journal
prism.volume 59
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