Wednesday, April 29, 2020


search

(1) Step One

https://accreditnet2.urac.org/UracPortal/Directory/DirectorySearch


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(2) Step Two

Program:  [Select Program]

Workers' Compensation Utilization Management


( Leave all other fields blank )


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(3) Click Search button







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URAC Directory of Accredited Companies

Search Criteria:
Company Name :
Program : Workers' Compensation Utilization Management
City :
62 record(s) found
ProgramStatus
Allied Managed Care Incorporated
Workers' Compensation Utilization Management - 7.4Full Accreditation
Arbitech Health, LLC
Workers' Compensation Utilization Management - 7.4Full Accreditation
Arissa Cost Strategies LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Artisan Claims Craft, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Ascential Care Partners, LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Athens Managed Care, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Bluegrass Health Network, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Briotix Health, Limited Partnership
Workers' Compensation Utilization Management - 7.3Full Accreditation
Broadspire Services, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
CareReview, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
CareWorks Managed Care Services, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Claims Eval, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
CompAlliance
Workers' Compensation Utilization Management - 7.3Full Accreditation
Compwest Insurance Co
Workers' Compensation Utilization Management - 7.3Full Accreditation
Concentra Health Services, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Conduent Care Solutions, LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
CorVel Healthcare Corporation
Workers' Compensation Utilization Management - 7.3Full Accreditation
Coventry Health Care Workers Compensation, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Dane Street LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
EK Health Services®, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Excel Managed Care & Disability Services Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
ExlService Philippines, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
ezURs.com, Inc
Workers' Compensation Utilization Management - 7.3Full Accreditation
GENEX Services, LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Hartford Fire Insurance Company
Workers' Compensation Utilization Management - 7.3Full Accreditation
Health Direct, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Intelligent Medical Solutions, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Intermed Cost Containment Services
Workers' Compensation Utilization Management - 7.3Full Accreditation
Liberty Mutual Managed Care, LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Marquee Managed Care Solutions, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
MAXIMUS Federal Services, Inc.
Workers' Compensation Utilization Management - 7.2Full Accreditation
Medata, Inc.
Workers' Compensation Utilization Management - 7.3Provisional Accreditation
MEDEX Managed Care, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
MediCall d/b/a Cognizant Technology Solutions
Workers' Compensation Utilization Management - 7.3Full Accreditation
MEDINSIGHTS, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Med-Masters, Inc. d/b/a Comprehensive Consulting
Workers' Compensation Utilization Management - 7.4Full Accreditation
MedReview, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Mitchell International, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
National Independent Review Organization, LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Nexus Enterprises, LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Novare Texas, LLC and Novare, LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Occupational Managed Care Alliance, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Omaha National Underwriters LLC
Workers' Compensation Utilization Management - 7.3Full Accreditation
Paladin Managed Care Services, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Professional Dynamics, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Promesa Health, Inc.
Workers' Compensation Utilization Management - 7.4Full Accreditation
RehabWest, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Risico Total Managed Care, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Rising Medical Solutions, LLC
Workers' Compensation Utilization Management - 7.4Full Accreditation
Sedgwick Claims Management Services, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
Shearwater Health, Inc DBA Shearwater Health Advisors, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
SIF Consultants of LA, Inc.
Workers' Compensation Utilization Management - 7.4Full Accreditation
SpecialtyHealth, Inc.
Workers' Compensation Utilization Management - 7.4Full Accreditation
Status Inc. dba Status Medical Management
Workers' Compensation Utilization Management - 7.3Full Accreditation
The Alaris Group, Inc. d/b/a Paradigm Complex Care Solutions
Workers' Compensation Utilization Management - 7.3Full Accreditation
The P & S Network, Inc.
Workers' Compensation Utilization Management - 7.4Full Accreditation
The Travelers Indemnity Company of Connecticut
Workers' Compensation Utilization Management - 7.3Full Accreditation
The Zurich Services Corporation
Workers' Compensation Utilization Management - 7.3Full Accreditation
TJ Holdings, LLC, dba PRIUM
Workers' Compensation Utilization Management - 7.3Full Accreditation
TRISTAR Managed Care, Inc.
Workers' Compensation Utilization Management - 7.3Full Accreditation
USIS, Inc. d/b/a AmeriSys
Workers' Compensation Utilization Management - 7.4Full Accreditation
York Risk Services Group, Inc.
Workers' Compensation Utilization Management - 7.2Full Accreditation
Search Again

urac maximus




URAC directory 62 companies
Workers' Compensation Utilization Management
https://accreditnet2.urac.org/UracPortal/Directory/DirectorySearch/List/6e5f1f78-17d7-4b31-9753-77a2097af34f



URAC directory search page
https://accreditnet2.urac.org/UracPortal/directory/directorysearch



California Designates URAC
https://www.urac.org/press-room/california-names-urac-designated-accreditor-workers-comp-utilization-review

URAC workers compensation utilization Accreditation
https://www.urac.org/press-room/california-names-urac-designated-accreditor-workers-comp-utilization-review

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Zurich
https://www.zurichna.com/claims/medical-management


Coventry
https://coventrywcs.com/content/Menu/Home/Solutions/Clinical_Solutions/Utilization_Review_Physician_Advisor_Services.html


EK Health
https://www.ekhealth.com/referrals/utilization-review2/



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Sunday, April 26, 2020

Week 5 Discussion topics UC SD obvious

discussion topic:
 
What factors would make an invention obvious to a person of ordinary skill in the art?  
 
Please post here in the discussion board about this topic. Then, also comment on posts from two other students in the class.   
      
Each of the weekly question posts are worth 10 points towards the final grade.          
Discussion Board participation is worth 20% of your grade.        


 topic:
 
What factors would make an invention obvious to a person of ordinary skill in the art?  
 
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Saturday, April 25, 2020

UC SD Patent survey from the mountain get started first step

Session 4 discussion topic:   

How does an inventor benefit 
from claiming priority 
to his/her earlier patent application?    

Please post here in the discussion board about this topic. Then, also comment on posts from two other students in the class. 

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Answer:
[blank]  give the inventor an advantage on the patent race in the first to file AIA regime 

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https://www.mintz.com/insights-center/viewpoints/2231/2018-07-understanding-priority-claims-us-patent-applications-part-1

https://www.mintz.com/insights-center/viewpoints/2231/2018-11-understanding-priority-claims-us-patent-applications-part-2

https://www.uspto.gov/web/offices/pac/mpep/s211.html


http://www.patenttrademarkblog.com/patent-priority-claim/


https://ocpatentlawyer.com/priority-claim-patent-application/



https://www.natlawreview.com/article/understanding-priority-claims-us-patent-applications-part-1

https://www.natlawreview.com/article/understanding-priority-claims-us-patent-applications-part-2

https://www.wipo.int/pct/en/faqs/faqs.html

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Approximately a decade later, the AIA abandoned the United States’ relatively distinctive “first to invent” approach under which the 16key priority date for many purposes of patentability is the date of the invention, the first date by which it is understood to have been both conceived and actually or constructively reduced to practice. Instead, the resolution of priority races under the AIA turns essentially exclusively on the date that a relevant patent application was filed or a qualifying public disclosure of the invention was made. Hence, the AIA brought the United States closer to, albeit not totally into alignment with, the “first to file” approach of many other countries under which the pertinent application filing date is the key determinant of patent priority.

(Golden,John, 01/2018, pp. 15-16)

Golden,John, Kieff,F., Newman,Pauline, Smith,Henry.  (01/2018). Golden, Kieff, Newman, and Smith's Principles of Patent Law, Cases and Materials,  7th Edition [VitalSource Bookshelf version].  Retrieved from vbk://9781640208551

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http://maioranapc.com/blog/USPTO-priority-date.htm


https://www.uspto.gov/web/offices/pac/mpep/s210.html


https://www.uspto.gov/web/offices/pac/mpep/s211.html

https://www.uspto.gov/web/offices/pac/mpep/s1828.html

http://www.patenttrademarkblog.com/priority-date/

http://www.bpmlegal.com/howtoterm.html

https://www.finnegan.com/en/insights/blogs/prosecution-first/mpep-update-new-guidance-regarding-effective-prior-art-dates-under-102e.html

Polk Wagner
http://www.stanfordlawreview.org/wp-content/uploads/sites/3/2013/03/WagnerAbrams_65_Stan._L._Rev._517.pdf






Wednesday, April 22, 2020

PFC off load ~ time the release for optimal reception

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The 3 most Common types of cases that I saw
when I worked with Maximus were ...

#1.  Medication prescriptions.
For example, Motrin and Vicodin refills.
There were a lot of medication refill requests.

2.  Physical Therapy PT requests.

3.  MRI requests.

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As I did more cases, I got more comfortable
with more differenty types of procedures.
For example, I would review obvious and easy request for lumbar spine epidurals.

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You can choose only cases in your comfort zone
within your Internal Medicine Specialty.

You can decline to accept a case
and return the case back to Maximus
if the subject is outside the scope of your comfort zone.

For example, if the case is request for brain surgery.
You would return the case saying that brain surgery is
outside the scope of your speciality Internal Medicine.

I would return any cases that I did Not like.
There was no problem with Maximus,
they would reassign the case to another doctor.

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You can start slow with a few cases.

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Maximus is a large corporation on the NYSE stock exchange.
MMS
https://www.marketwatch.com/investing/stock/mms

Maximus also has full time positions with benefits
and medical director and administrative positions
for physicians who  have gained experience within Maximus.

Many of the physicians work remotely.


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Tuesday, April 21, 2020

mmm

Recommended Steps and Sequence:

1.  Apply for California Medical License

2.  Apply for Malpractice Insurance

3.  Apply for Maximus ~ Specify California Workers Comp IMR program


_______________________

Why I like Maximus:

*High Volume.
Maximus is the only exclusive administrator for the
California Workers Comp IMR program
which has One Million cases per year.

*Template based.
The IMR process is standardized
which means that you can make and use templates
to make things quick and easy.
I have many many templates that you can use.
I will give you my templates.

*Online, work from home.

*Flexible
You can adjust the volume up or down.

_______________________

California License is required for this program.
Malpractice is required.
That is why you get these first.

_______________________

(1) California Medical Board

https://www.mbc.ca.gov/Applicants/Physicians_and_Surgeons/

_______________________

(2) Malpractice Insurance
https://www.capphysicians.com/

Apply Malpractice
https://apply.capphysicians.com/register


_______________________

(3) MAXMUS
Opportunities for Healthcare Professionals
https://maximus.com/corporate-information

ProfessionalRelations@maximus.com

Physician reviewer application
https://maximus.com/sites/default/files/documents/Physician_Consultant_Credentialing_Application_508.pdf


Maximus IMR
California Work Comp
https://maximus.com/case-study/transforming-medical-appeals-process-california-workers-compensation-program


One Million Cases process annually
https://maximus.com/capability/appeals-imr


California Government Website
https://www.dir.ca.gov/dwc/IMR.htm


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_______________________

MIRAMAR May 18 reg

ABA Page 3


________________


CUYAMACA

https://selfservice.gcccd.edu/Student/Courses

https://www.cuyamaca.edu/current-students/schedules/default.aspx


______

MIRAMAR
https://myportal.sdccd.edu/psc/CSGUEST/EMPLOYEE/EMPL/c/NUI_FRAMEWORK.PT_LANDINGPAGE.GBL?Page=PT_LANDINGPAGE&Action=U&LP=EMPL.EMPLOYEE.X_IH_CS_GUEST_FLUID


Search Classes
https://myportal.sdccd.edu/psp/CSGUEST/EMPLOYEE/SA/c/COMMUNITY_ACCESS.CLASS_SEARCH.GBL?X_DEF_OPT=CLASS_SRCH_WRK2_ACAD_CAREER%24268%24&X_DEF_VAL=UGRD


Class Schedule
https://myportal.sdccd.edu/psc/CSGUEST/EMPLOYEE/EMPL/c/NUI_FRAMEWORK.PT_LANDINGPAGE.GBL?Page=PT_LANDINGPAGE&Action=U&LP=EMPL.EMPLOYEE.X_IH_CS_GUEST_FLUID


Miramar  Summer Classes

http://sdmiramar.edu/sites/default/files/documents/2020-04/SUMMER%202020%20CLASS%20LIST%20FOR%20SS%20AND%20PIO%20-%20DATA%20AS%20OF%20APRIL%2010%2C%202020.pdf

https://www.sdmiramar.edu/

Courses
http://www.sdmiramar.edu/programs/paralegal/certificate



https://www.sdccd.edu/about/departments-and-offices/instructional-services-division/curriculum-services/publications/class_schedule.aspx


4/20 Mon Student Systems Support Technician Post Summer 2020 class schedule to the web
https://www.sdccd.edu/docs/ISPT/instsrv/Timelines/2205prod_by_date.pdf


MIRAMAR
PARA  105 Legal Research

PARA 110   Legal Writing & Communications


https://www.sdmiramar.edu/programs/paralegal




PDF
http://sdmiramar.edu/sites/default/files/documents/2020-04/SUMMER%202020%20CLASS%20LIST%20FOR%20SS%20AND%20PIO%20-%20DATA%20AS%20OF%20APRIL%2010%2C%202020.pdf

Sunday, April 19, 2020

j

MAXIMUS
https://maximus.com/capability/appeals-imr

Maximus & California Workers Comp
1 million IMR cases annually
https://maximus.com/case-study/transforming-medical-appeals-process-california-workers-compensation-program




Medical Director Job Description
https://external-maximus.icims.com/jobs/51022/medical-director-(remote!)/job

kimdonselaar@maximus.com

California Workers Comp

Independent Medical Review (IMR)
https://www.dir.ca.gov/dwc/IMR.htm

DWC Physician Education
https://www.dir.ca.gov/dwc/CaliforniaDWCCME.htm

FAQs  IMR  California
https://www.dir.ca.gov/dwc/IMR/IMR_FAQs.htm


https://www.capphysicians.com/

https://apply.capphysicians.com/register


https://www.mbc.ca.gov/Applicants/


https://www.mbc.ca.gov/Applicants/Physicians_and_Surgeons/