Workers’ Compensation Claims Handling Timelines The NARS Way – WC Claims Handling Timelines Must be paid within 3 days of approval and within 30 days of Medical Payments receipt. ARC Payments Within 3 business days of All mail should be labeled, filed, and worked New Mail receipt accordingly. Phone and Email Within 24 hours or 1 business Prompt responses within 24 business hours of Communication day. receipt for all communications. Initial QCM is due by day 15, The QCM should cover a thorough review of all second review is day 30, QCMs claims handling guidelines and completion of C3 Quality Case Management thereafter follow the status mandatory requirements and give strategic Review or QCM report timeline. direction where needed. Reassigned File Review within 7 days Bulk reassignments are excluded. Must be completed within 10 business days of receipt of any settlement demand and or when the claim has reached settlement maturity, Settlement Evaluations Within 10 business days whichever comes first. Within 2 business days of The payment must be documented in the file Settlement Payments receipt notes Within 3 business days of any client request and or red flag identification SIU Referral Within 3 business days Subrogation Referral Within 14 days This will be captured in the compensability entry Within 10 days of claim receipt. Confirmation status report on day 30 from receipt of the The plan should be proactive and should have claim. Medical Only follow-up ultimate file resolution as the vision. Address any status report every 60 days and red flags and plans to mitigate the claim thereafter, Lost Time claims exposure. every 45 days thereafter and Status Report long-term Medical Check every two hours for reserves and payment release. Reserve Approvals >50K require a note in the file by the UM. Approvals >500K require a Unit Manager and Director– Released and approved several note in the file from the Director. Payments and Reserves times daily. Call 2 injured workers per specialist per month. Track all calls by Claim Number, Name, Client, Complete 2 per specialist per Date and Response. UM Success Calls month. Must be paid within 3 days of approval and within 30 days of C3 Payments Vendor Payments receipt NARS’ Best Practices were created by and for the internal use of NARS and are confidential, proprietary and trade secret documents protected by the Uniform Trade Secrets Act and applicable state/federal law. They may not be copied, distributed, or reproduced, in whole or in part, without NARS’ express prior written authorization. Unauthorized use or distribution may be subject to civil and/or criminal penalties.