Fort Worth mayor on workers comp audit: ‘We don’t deal with average performers’

April 07--FORT WORTH -- Fort Worth's grade on a state assessment of the city's handling of workers compensation cases has dropped since CorVel Enterprise Comp was hired to handle claims, a report from the Texas Department of Insurance shows.

In the 2014 state report, included in the results of a city-commissioned outside audit of CorVel, Fort Worth's score dropped from 97.88 percent in 2012 (when the city had a different administrator for workers comp claims) to 92.67 percent.

Also, the city's audit found, CorVel has communicated poorly with city employees. The outside audit was begun after Mayor Betsy Price blasted the company in January for directing "inflammatory questions" to the family of a wounded police officer.

"We have counseled them over and over again that they simply have to do a better job of communicating with our employees and adding a layer of empathy and a caring attitude to this," Price said, adding that she was glad she called for the audit.

"It makes me concerned that we didn't call for it sooner. It is a shame it took a serious tragedy like that to force us to call for this. It served as a wake-up call."

Sgt. S. Drake, a 19-year veteran of the Fort Worth Police Department, was shot in the abdomen in the line of duty on Jan. 29 and was taken to Texas Health Harris Methodist Hospital in Fort Worth. The next day, Drake's family and other officers said a CorVel nurse case manager directed inappropriate questions to family and other police officers. CorVel has said the nurse acted professionally.

Bennie Stoner, a senior vice president for CorVel, said in an email that company officials are pleased that the city's audit "found no indication that CorVel inappropriately denies claims or pre-authorization of medical treatment, or processes claims in any unfair manner."

The audit found that the denial of claims over the last three years is far below the state average, with 4.2 percent of claims denied in full, compared with a 12.6 percent denial rate for claims statewide.

However, the audit also found that denials of preauthorizations -- authorizations for treatment sought in advance, such as for physical therapy -- have risen from 17 percent to 28 percent in the three years since CorVel was hired by the city.

The reason for that is at least partly because of new state regulations, the audit says. Still, Price said, it is a cause for concern because it is a "significant" jump.

Stoner said in the email that CorVel will "analyze the audit to determine how it can improve its service to the city of Fort Worth."

State score lowered

In the state report, complied by the Texas Department of Insurance Division of Workers Compensation, Fort Worth was one of only three municipalities of 26 scored that did not rank as a "high performer" in 2014. The report studied timely payment of benefits; timely processing of initial medical bills, timely processing of requests to cover medical bills and other data.

"That is disappointing," said Brian Dickerson, Fort Worth's human resources director. "We would expect that to be higher."

Price agreed, saying: "Most municipalities, especially Fort Worth, we don't deal with average performers. We want someone that is above average to help our employees, especially in times of crisis."

The list of "high performers" included the city of Dallas, Tarrant County and the Fort Worth school district.

The city's audit of CorVel, conducted by McGriff, Seibels & Williams, a healthcare and workers comp consulting company, found "poor communication" was "a common theme" in the complaints filed against CorVel.

"We want to immediately address the communication; that is No. 1," said Dickerson. "Then, No. 2, delve into what is the plan to increase the score for the next year on the [state] report."

CorVel's contract runs out in December. Dickerson said the city will seek requests for proposals for the third party administrator job.

"We are going to do something different than we have done in the past, because just changing the third party administrator isn't going to change anything," Dickerson said.

Jim Tate, president of the Fort Worth Professional Firefighters Association, said the audit let CorVel "off a little light," but he said he was pleased the city was creating a request for a new vendor.

"If CorVel can stack up, then I'm sure they will be back, but I don't think they will be. I think the audit found there were deficiencies," Tate said.

Caty Hirst, 817-390-7984

Twitter: @catyhirst

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