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Nevada_Executive_Budget_2013-2015

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Activity: Insurer, Medical Compliance<br />

This activity reviews claims processing functions to ensure compliance with NV workers'<br />

compensation statutes and regulations, investigates injured workers' complaints, and assists with<br />

the routing of C-4 forms to the proper insurer to ensure benefits are provided to injured workers.<br />

Performance Measures<br />

1. Insurer/Third Party Administrator/Medical Provider Investigations<br />

2012 <strong>2013</strong> 2014 <strong>2015</strong><br />

Type: Actual Projected Projected Projected<br />

Percent: 95.90% 95.99% 96.50% 97.00%<br />

2. Insurers, Third Party Administrator/Medical Providers Compliance<br />

2012 <strong>2013</strong> 2014 <strong>2015</strong><br />

Type: Actual Projected Projected Projected<br />

Percent: 93.82% 95.99% 96.50% 97.00%<br />

3. Claim Form (C-4) Routing<br />

2012 <strong>2013</strong> 2014 <strong>2015</strong><br />

Type: Actual Projected Projected Projected<br />

Percent: 6.75% 10.02% 10.03% 10.02%<br />

Population / Workload<br />

1. <strong>Nevada</strong> Employees<br />

2011 2012 <strong>2013</strong> 2014 <strong>2015</strong><br />

Type: Actual Projected Projected Projected Projected<br />

Amount: 1,114,639 1,115,000 1,115,000 1,115,000 1,115,000<br />

2. <strong>Nevada</strong> Insurers/Third-Party Administrators<br />

2012 <strong>2013</strong> 2014 <strong>2015</strong><br />

Type: Actual Projected Projected Projected<br />

Amount: 561 561 561 561<br />

3. <strong>Nevada</strong>'s Workers Compensation Physicians<br />

2012 <strong>2013</strong> 2014 <strong>2015</strong><br />

Type: Actual Projected Projected Projected<br />

Amount: 3,705 3,705 3,705 3,705<br />

Resources<br />

Funding FY 2014 FY <strong>2015</strong><br />

Other $ 1,935,642 1,696,857<br />

FTE 21.30 21.30<br />

TOTAL $ 1,935,642 1,696,857<br />

FTE 21.30 21.30<br />

Objectives FY 2014 FY <strong>2015</strong><br />

Customer Service (Business<br />

Development and Services)<br />

967,821 848,429<br />

Compliance (Business<br />

Development and Services)<br />

967,821 848,429<br />

DEPARTMENT OF BUSINESS AND INDUSTRY B & I - 66<br />

B&I - INDUSTRIAL RELATIONS DIV

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