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Injured Worker Employers
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Medical Services

Claims Navigation in Today’s Economic & Legislative Climate     
           Physicians, Hospitals, Nursing Homes,
Convalescent Homes, Residential Care Facilities, Ambulance Services

Unique Expertise

SmartComp’s team is experienced in providing claims management services to a wide range of providers in the Medical Services Industry.  We have the capability and expertise required to handle the most complex injuries.

 

Focused On Results

SmartComp has a dedicated claims team that partners with our clients in the day to day management of the claims process. Being On-Site, On-Time and On-Target we provide an alternative to the high cost of claims associated with the Medical Services Industry.

 

On-Site Claims Navigation

Whether you’re a Physician, Hospital, Nursing Home, Convalescent Home, Residential Care Facility or Ambulance Service SmartComp’s team of on-site claims management specialist are available to strategically navigate you and your injured worker through the Workers’ Compensation system.

 

 

Class Codes - Included by not limited to:

 

 

8834 - PHYSICIANS — all employees — including Clerical Office Employees This classification shall not be used for division of payroll in connection with any other classification (other than Standard Exception Classification 8742(1), Salespersons — Outside, or General Exclusions) unless the operations described by Classification 8834 constitute a separate and distinct enterprise having no connection with the operations covered by any other applicable classification.

 

Pure Premium Rate:  2015 (1.60), 2014 (1.50), 2013 (1.36), 2011 (.98)

Expected Loss Rate: 2015        (), 2014 (  .48), 2013 (  .51), 2011 (.49)

 

 

9043 - HOSPITALS — all employees — including Clerical Office Employees and Outside Salespersons The payroll for student nurses and interns shall be included at an average wage of at least $100 per week.

 

This classification applies to facilities that are licensed by the California Department of Public Health as a General Acute Care Hospital, Acute Psychiatric Hospital or Special Hospital. Hospitals retain medical staff with the capability to provide 24-hour inpatient care.

A medical clinic that operates at a location separate from the hospital shall be classified as 8834, Physicians, provided the clinic does not provide 24-hour inpatient care.

Hospitals operated by municipal, state or other public agencies shall be classified as 8830, Institutional Employees.

Hospitals operated in connection with jails or prisons shall be classified as 7720, Police, Sheriffs, Constables, Marshals, Animal Control Officers, Game and Fish Wardens, and Jailers.

Pure Premium Rate:  2015 (2.32), 2014 (2.31), 2013 (1.99), 2011 (1.58)

Expected Loss Rate: 2015        (), 2014 (  .78), 2013 (  .78), 2011 (  .79)

 

 

8829(1) - NURSING HOMES — all employees

Nursing homes engage in the provision of skilled nursing care and supportive care to patients whose primary need is the availability of skilled nursing care on an extended basis. These facilities provide 24-hour inpatient care including medical, nursing, dietary and pharmaceutical services.

 

Pure Premium Rate:  2015 (6.31), 2014 (6.10), 2013 (5.54), 2011 (3.42)

Expected Loss Rate: 2015        (), 2014 (2.03), 2013 (2.14), 2011 (1.71)

 

 

8829(2) - CONVALESCENT HOMES OR CONVALESCENT HOSPITALS — all employees

Convalescent homes engage in the provision of skilled nursing care and supportive care to patients whose primary need is the availability of skilled nursing care on an extended basis. These facilities provide 24-hour inpatient care including medical, nursing, dietary, and pharmaceutical services.

 

Pure Premium Rate:  2015 (6.31), 2014 (6.10), 2013 (5.54), 2011 (3.42)

Expected Loss Rate: 2015        (), 2014 (2.03), 2013 (2.14), 2011 (1.71)

 

 

9070(1) - RESIDENTIAL CARE FACILITIES FOR THE ELDERLY — N.O.C.

Classification 9070(1) shall not be used for division of payroll in connection with Classifications 8804(1), Substance Use Disorder Recovery Homes, or 8804(2), Social Rehabilitation Facilities for Adults, unless the operation described by Classification 9070(1) constitutes a separate and distinct enterprise having no connection with the operations covered by Classifications 8804(1) or 8804(2).

This classification shall apply to those firms that provide nonmedical care and supervision to their residents. Such services include, but are not limited to, assisting residents with dressing, eating, personal hygiene and taking medications.

A separate unit is operated at the same location for the provision of congregate living services only (no care and supervision) shall be separately classified as 8851, Congregate Living Facilities.

Skilled nursing care provided at the same location as an identifiable unit shall be separately classified as 8829(1), Nursing Homes.

When the residential care facility operates units at the same location that are classified as 8851, Congregate Living Facilities, and/or 8829(1), Nursing Homes, employees common to all operations including, but not limited to, food services, laundry, maintenance, security and supervisory employees shall be assigned to the Governing Classification (See Section II, Classification Terminology, for the definition of “Governing Classification”.)

Pure Premium Rate:  2015 (10.46), 2014 (10.73), 2013 (10.39), 2011 (5.57)

Expected Loss Rate: 2015          (), 2014 (  3.56), 2013 (  3.98), 2011 (2.71)

 

 

7332 - AMBULANCE SERVICES — all operations

 

Pure Premium Rate:  2015 (5.90), 2014 (6.23), 2013 (5.42), 2011 (4.10)

Expected Loss Rate: 2015        (), 2014 (2.09), 2013 (2.16), 2011 (2.09)

 



 

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