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MTRMA's Claim Staff consists of qualified professionals (Claims Supervisor, Claim Representatives, Claim Adjusters, Managed Care and Nurse Case Management) who review and evaluate each claim the moment the first notice of loss is received and continues the process throughout the life of the claim. All claims are aggressively and proactively managed to reach appropriate resolution quickly, effectively and efficiently. MTRMA members are encouraged to discuss their claims with their representative and to be involved in the decision making process. We are committed to controlling and mitigating your workers' compensation costs and achieving a long-term relationship with our members. MTRMA has experienced stellar claim performance in terms of total incurred losses in comparison to the industry for the 5-year period 2000 thru 2004. MTRMA's average cost per indemnity claim is $23,362, 31% less than the average for Illinois insurance carriers during this same period of $34,096. 
Managed Care |
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Our managed care services (comp mc) are designed to reduce the overall cost of medical claims, integrate the expertise of medical professionals into the claims process to better coordinate treatment and ensure that the injured employee receives quality medical care. Workers' Compensation costs continue to escalate and are currently two times that of the general medical rate.The key components for comp mc are preferred provider networks, bill review, utilization review, utilization/disability management and reporting. With this in mind, our technology permits us to eliminate excessive charges, duplicate charges, and identifying billing infractions. Utilization review or proactive nurse case management results in a decrease in medical costs and can often result in claimants returning to work in a timely manner decreasing the claims cost. We also utilize a national diagnostic scheduling network that provides quick turnaround for scheduling diagnostic testing and obtaining the reports from those tests. comp mc also has an integrated RX pharmacy program tied directly to our bill review software and proprietary claims software. This allows us to capture "First Fills" and adjudicate pharmacy claims directly on-line at the time of the dispensing. First Fills account for 80% of all pharmacy costs. The comp mc RX pharmacy program ensures pricing below state fee schedule or usual and customary rates and allows reports to reflect pharmacy costs as they relate to total medical expenditures. iCE |
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iCE is our Internet claims edge that allows members to log on individually to view their company's claims live. With iCE, you are able to view claim detail, financial transactions, produce a variety of reports, charts, graphs, analyze trends, and report claims on-line. This is offered to MTRMA members free of charge.If you have a specific question regarding claims, please contact your claim representative: Click here to access iCE.Deb Blinn, Supervisor, , 800.252.5059, ext. 1187 Cathy Green, Representative, , 800.252.5059, ext. 1271 Lori Downing, Representative, , 800.252.5059, ext. 1143 Janet Reffett, Representative, , 800.252.5059, ext. 1314 Thelma Taflinger, Assistant, , 800.252.5059, ext. 1266 |