The Percy Program

It is a fight to level the playing field to be able to compete for jobs and careers on the basis of skills and make available apprentice training to all. In 1973 Al Percy launched a class action lawsuit to give workers like him a chance to better their lot in life. It would also ensure the availability of skilled workers to build the infrastructure of the future.

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Percy Program - Alternative Employment Practice EDNY 20-cv-06131

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Case

Case 1:20-cv-06131-CLP Document 22-21 Filed 03/14/21 Page 48 of 64 PageID #: 2780 46 | P age

Case 1:20-cv-06131-CLP Document 22-21 Filed 03/14/21 Page 49 of 64 PageID #: 2781 CLAIMS MANAGEMENT/ADJUSTMENT Claim adjustment will occur using the claim adjusting staff of the direct insurer, or by engagement of third-party administrators (TPA’s) to adjust that have been vetted for their competence and experience in adjusting workers’ compensation claims. The vetting process includes a review of the TPA’s methods used to train adjusters and nurse case managers to ensure they adhere to Percy’s Claims Handling Practices manual and applicable laws and regulations. Workers’ compensation TP As are paid on a per claim basis. Early Claim Reporting Early reporting of claims and responsive intervention will assist in reducing and managing the costs and responsive intervention will assist in reducing and managing the cost of work related injuries. When lag times between reporting and care are reduced, injuries are worsened by delay and downstream medical costs are thereby reduced. The resulting increased satisfaction of injured workers has a commensurate reduction in litigation costs. Case Management The objective of case management is to utilize the medical expertise disposal to manage and minimize medical costs and reduce lost time claims. Case management is integrated with the return to work philosophy and program outlined below. Utilization Management Utilization Management is performed where specialized testing, inpatient or outpatient hospitalization is required, or extensive physical or chiropractic regimens are required. The primary goal of Utilization Management is to efficiently manage and meet the medical needs of the injured employee. Utilization Management allows oversight of whether treatment is medically necessary, and whether the duration and course of treatment is appropriate. Medical Bill Processing Medical bills are reviewed for consistency and appropriateness as gauged against the state mandated fee schedules, preferred provider (PPO) discounts available under contract, and, where applicable, reasonable and customary charges. Medical bill review assists in the identification of potential fraud and double billing, and provides assurance that the employer and employee do not pay for bills that are not their responsibility. 47 | P age

Alternative Employment Practice Percy Program