CASE STUDY

A quick fix of the Mod heals a financial wound for physicians' group

Company

A physicians’ group of over 40 doctors and nurse practitioners, with a total of 177 employees and annual revenues of $10 million.

Situation

The company had a higher than average Experience Mod, but the source of the problem was unknown.

Assessment

A Certified WorkComp Advisor (CWCA) used Mod software to determine the issue. By analyzing all factors, including the experience mod worksheet, loss-run reports, and payroll class codes, it was discovered that the Mod should have been considerably lower.  A discrepancy in an open claim, which was for an employee who was out of work with a strained shoulder, was the reason for the increased Mod.  It was $10,000 more on the experience mod worksheet than it was on the loss-run reports from the employer.

Solution

The account manager and producer on the account were notified of the discrepancy and it was reported to the Workers’ Compensation board, which corrected the error.

Result

By initiating the new audit, the CWCA pinpointed the mistake, made the proper adjustments and had the Experience Modification Factor reduced from 1.02 to .98, resulting in an immediate $3,500 refund. If the mistake hadn’t been discovered, the employer would have been overcharged $10,500 over the next three years.