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Claims Reporting Guide

Workers' Compensation Specialists

The Synergy Coverage Solutions claims staff is committed to providing you with quality, immediate claims management. Our website supplies clients with important information, downloadable documents, contact directory, and fast reporting resources to help manage employee claims and medical treatments. The Synergy Coverage Solutions website is located at:

www.synergyinsurance.net

Synergy Coverage Solutions, LLC | 217 South Tryon Street | Charlotte, NC 28202 | 704.927.2860

At synergyinsurance.net, you' ll notice the link to Report a Claim: this feature allow s online reporting of w ork related illness or injury:

Synergy Coverage Solutions claims staff will be notified immediately of any illness or injury, allowing the prompt handling of new claims. Online reporting of claims lets our staff respond rapidly to your claim, with quicker contact of the injured employee, medical provider and the employment loss preventions personnel. Quicker contact will result in less confusion on the part of the injured/ill worker and provide prompt

It is very important to file the claim with Synergy within 24 hours of the injury, so that we may begin our claims handling process as quickly as possible. We cannot stress enough the need for prompt reporting of new injuries.

Two claim reporting methods: Option A) If you've been given a username, you can login to report a claim online. Option B) If you do not have a user name, you can still use the forms available on our website.

Claim reporting forms for each covered state in PDF format.

Synergy Coverage Solutions, LLC | 217 South Tryon Street | Charlotte, NC 28202 | 704.927.2860

Prompt Claims Reporting Recent studies indicate prompt claims reporting can lower loss ratios up to 5%. This is accomplished by quicker attention to the injured worker, providing faster treatment and explaining the workers' compensation system to the injured employee. Industry studies have shown that the sooner an injured worker is contacted by the claims department the lower the over all cost of the claim, thereby reducing the need for litigation and educating the injured employee on the aspects of what workers' compensation benefits are available for compensable claims. Returning To Work Once an injury occurs the most effective cost reducing program an employer can implement is an "Early Return to Work Program". NC has become more of a wage loss benefit state over the past 10 years, meaning that we continue to pay lost wage benefits until an employee actually returns to work. Therefore, a formal "Return to Work" program is critical in reducing the over all cost of workers' compensation claims.

Synergy Coverage Solutions, LLC | 217 South Tryon Street | Charlotte, NC 28202 | 704.927.2860

PROVIDER NETWORK We have established a relationship with a Provider Network consisting of Primary, Ancillary, and Specialty Care Providers. This network is continuously being monitored and updated using staff and employer input. We direct medical care and assist in the management of medical treatment. Referrals to Specialist (orthopedics, neurosurgeons, etc.) must be approved by Synergy Claims Department. If an Injured Employee is referred to a provider other than the Primary Care Physician (Urgent Care) or in the event of an emergency, any referrals outside of this initial treatment must be approved by Synergy Coverage Solutions Claims Department.

The provider search button allows individuals to seach online for a doctor, hospital, or facility.

PHARMACY NETWORK Synergy Coverage Solutions provides a pharmacy network to employers in which we provide prescription coverage. The pharmacy network has several benefits: Prescriptions are filled at no cost to the injured workers as all bills are sent directly to Synergy Coverage Solutions. A discount has been negotiated on items billed through the pharmacy network. This discount reduces the cost of claims.

The overall effect is a reduction in prescript ion cost; t he injured w orker has no out of pocket expense for his/her prescription cost and an overall reduction in t he cost of the w orkers' compensation claims.

Synergy Coverage Solutions, LLC | 217 South Tryon Street | Charlotte, NC 28202 | 704.927.2860

To locate a network pharmacy or provider, please visit our website (www.synergyinsurance.net). There are links in the quick links section called "Network Pharmacists" and "Network Medical Providers". This links will provide you with the information needed to find a network medical provider or pharmacist

The program pharmacy network includes (but is not limited to): Medicap Pharmacy Bi-Lo Pharmacy Medicine Shoppe Publix Pharmacy Rite-Aid Pharmacy Target Pharmacy CVS Pharmacy K-Mart Pharmacy Kerr Drugs Kroger Drug Wal-Mart Pharmacy Walgreens Winn Dixie Pharmacy

Synergy Coverage Solutions, LLC | 217 South Tryon Street | Charlotte, NC 28202 | 704.927.2860

Synergy Coverage Solutions, LLC 217 South Tryon Street Charlotte, NC 28202

704.927.2860 704.927.2867 fax 866.710.0908 toll free http://www.synergyinsurance.net [email protected] Fax

704.927.6193 704.405.5525 704.927.4323 704.927.4329 704.927.6184 704.405.9451 704.405.5529 704.927.4375 704.927.4324 704.927.4321 704-927-2867 704.405.0929 704.927.4328 704.405.5531

Name

Beth Spangler Claims Supervisor Robert Parkins Claims Supervisor Sara Collins Senior Claims Adjuster Cindy Jackson Senior Claims Adjuster Sandra Lumsden Senior Claims Adjuster Ryan Haywood Claims Adjuster Kim Stringer Senior Claims Adjuster Patti Wise Senior Claims Adjuster Erica Furr Medical Only Claims Adjuster Candi Vardo Claims Adjuster Dawn Koszyk Medical Bill Review Specialist Ellen Carr Medical Bill Review Assistant Anne Hartnett Medical Only Adjuster John Stoehr Senior Claims Adjuster

Phone

704.927.3274 704.405.5524 704.927.3272 704.927.7031 704.927.6183 704.405.9450 704.405.5528 704.927.4327 704.927.7032 704.927.2886 631.567.1902 704.405.0928 704.927.6185 704.405.5530

Email

[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected]

Synergy Coverage Solutions, LLC | 217 South Tryon Street | Charlotte, NC 28202 | 704.927.2860

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Claims Reporting Guide

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