Payor/Carveout Quiz

What is a payor/carveout?

A specific branch of the WCI company

Different WCI companies with the same first name

Specific employer groups under the same WCI company

A specific group of Adjusters who only handle one employer

True or False: An Adjuster's name be listed under more than one careveout for the same WCI company?

True

False

True or False: Client directives for each WCI carveouts are the same, example: Sedgwick and Sedgwick/Albertsons

True

Fasle

True or False: When cloning/creating a referral you should always check the claims feed for the WCI listed.

True

False

Select all that apply: When cloning/creating a new referral if you are adding/updating an adjuster and more than 1 option is populating for the same WCI company due to a carveout, what information should you look for to make the correct selection?

Branch location

Employer

Adjusters signature information

Patients Injury state

If you are unable to locate the patient in the claims feed, select "Cannot Find Patient" and then look for which of the below information if the adjuster is pulling up as shown above:

Check for employer information on all dcouments to see if UPS or ADP is listed.

Check Adjusters signture to see if UPS or ADP is listed.

If unable to find information on the employer select the "Base" Liberty Mututal option.

If unable to find any information on the employer send to ExceptionsReAuth

Based on the infomration above, which of the Employer Company would you select?

ADP

UPS

Wawa

Liberty Mutual

Based on the information above, which of the Employer Companies would you select?

ADP

UPS

Wawa

Liberty Mutual

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