The Claims Detail report is used to get an overview of a portfolio of claims and easily spot the expensive or inactive ones.
The report has a row for each claim with basic claim info, status, dates, and current budget (both paid and reserve). Special highlights for reserve changes > $10,000 and % Reserve Used over 85%.
The budget numbers are adjusted for % Liability with the appropriate rules to determine the right % (see notes below).
Parameters:
Employer Program (required) selects the retro or TPA program to be included in the report and in the Employers parameter drop-down. Default is the first retro group found so if your firm manages only one retro group no selection is needed.
Employers (optional) allows you to narrow results to a specific employer account or group of employer accounts. If left showing None Selected, all active and inactive accounts (including internal, administrative accounts) will be included.
^Let me pick inactive employers^ checkbox determines whether inactive employers are included in the choices for selection in the Employers parameter. To see only active employers, leave the checkbox unchecked (the default selection) and Select All (or a subset of) the employers in the Employers parameter.
Start Date and End Dates (required) filter results to claims that have a Date of Injury (DOI or DOLIE) falling within the date range.
Claim Type parameter (optional) lets you restrict results to a particular claim type or types. This is the Claim Type that is manually entered in each case/claim in the Basic Info section of the Claim sub-tab, Claim Info main tab; this is not the L&I claim type.
Claim Open/Close Status (optional) has values of Open, Closed, or Undetermined, and restricts results to claims in the selected status(es).
Case Lead (optional) lets you select a case lead or group of case leads to focus on in the report.
Claim # parameter (optional) allows you to specify a State Claim Number to check the budget and status for that claim.
Show only claims with these tags parameter (optional) lets you limit results to claims with a particular tag(s).
Notes:
Claim Type uses the claim type value that is manually entered in each case/claim in the Basic Info section of the Claim sub-tab, Claim Info main tab; this is not the L&I claim type.
Last Case Note is the date the most recent case note or To-Do for that claim was completed.
Paid (actual cost) numbers represent the portion of costs for which the employer is liable. % Liable is always 0% for denied claims, 100% for accepted claims not identified as third party, and 50% for accepted third party claims.
Occupational disease claims have the % Liable value assigned by L&I.
Reserve numbers, also adjusted for % Liable, show what is recorded at L&I for both open and closed cases.
% Reserve Used is highlighted with bold, red text if greater than 85%.
Time Loss Days is the number of days estimated by L&I.
Location code column will first use the Employer Location Code, if populated. If it is not, we will then use the Insurer Location Code, if populated.