Basic Training Guide
Training Day 1 Introduction to the Company
o Welcome: meet the new person out front with entire staff. o Although you will want to introduce yourself when they first arrive, the assigned team lead will escort them upstairs for a brief meeting before the training will begin o Take a tour of the building and introduce the staff o New Hire Paperwork o Towards the back of the training manual there are several forms that will need to be filled out by the trainee. All forms may be completed no later than the first Friday after the date of hire. ___ Handbook acknowledgement ___ Direct Deposit Form ___ Forms I-‐9 and W-‐4 ___ Copies of a DL and SSC ___ Confidentiality Agreement ___ Emergency Contact Form o After all paperwork has been completed, have the trainee remove the perforated pages from the manual and submit them to your team lead. o Company History o Owners: Corey Cormier, Danny Daniel and Jonathan Stark. Explain each of their roles are as owners but also what their other full-‐time responsibilities entail. Introduce them to the new hire. o Developers: Corey Cormier, Jack, Igor, Andrey, and Eugene o Team Leads: Introduce them to the new hire § Christy Brake – Specializes in Accounting and WebARC; Teams include Chasen & Boscolo, Crumley, Daniel Stark, Schechter, and Zanes. § Kerry Snow-‐Alley – Specializes in Strategy Planning Affidavits and FTE (Full Time Equivalent); Teams include Berg, Brown, Carter, Kuvara, Lundy, and McDivitt,. § Jessica Varley – Specializes in Hiring, Training, and Systems; Teams include JMB, Nunn and Sawaya. o Legal Monkeys vs. Automated Records Collection o Legal Monkeys is the name of our company and ARC is our product. o What is WebARC and what are its functions? o WebARC is Record Retrieval Software. It integrates with Needles case management software allowing legal firms to request records through WebARC. Once legal firms have requested a record, the software will check to make sure all the request data is complete and accurate. If the
request passes these requirements, then the software generates and sends the request to the provider. The Record Retrieval Software organizes all the outstanding requests, grouping them by provider and allowing the user to efficiently follow-‐up on all outstanding requests. Once the requests are received, the software allows for quick and accurate processing of the incoming record. o Have the trainee read the short story answering the question of “Where did the idea for ARC come from and how did we develop into what we are today? Introduction to Automated Records Collection o Describe a Personal Injury Claim o A personal injury claim is a means for a person to collect damages if he or she is injured by the actions or negligence of another entity. o Personal injury claims are designed to help the victim recoup monetary losses or debt incurred because of the injury, such as medical or hospital bills. o The compensation the victim receives from the insurance company is typically based on the total amount of medical expenses, income lost due to the injuries and damages for pain and suffering. o Most personal injury attorneys are paid by contingent fees. This means that there is only a fee for their services if there is a favorable result. The attorney will only charge the client a fee if the claim is successful, and the fees are usually calculated as a percentage of the client’s net recovery. o Describe how a case works o A person is injured as a result of someone else’s negligence. o They may be the victim of an auto accident, a dog bite, a slip and fall, medical malpractice, etc. o An attorney can help these victims by handling the insurance companies and working towards a financial recovery while the injured party focuses on getting medical treatment and putting their life back together. o Signing up a case o Personal injury attorneys don’t take every case; successful PI claims must contain the following elements: 1) Liability – Is the other party at greater fault than our client? 2) Collectability – Does the at-‐fault party have insurance or big assets? 3) Damages – Has our client been injured? What does the property damage look like? Are there major gaps in our client’s treatment history thus far? o Determining whether these elements are fulfilled early will help the attorney decide if the case is valuable and worth pursuing in their firm. o When an attorney signs up a case, the client will complete several pieces of paperwork including a HIPAA-‐compliant medical authorization that authorizes healthcare providers to release the client’s medical records and bills to the attorney (and ARC). o After a case has been signed up, it will cycle through the following phases:
1. Case Opening 2. Treatment 3. Waiting on Medical/Demand Prep 4. Demand 5. Settlement Negotiations 6. Case Disbursement o The attorney maintains regular contact with their client throughout the case, but typically does not handle the daily management of it until the settlement phase is reached. o Primarily a case manager or legal assistant handles all of the other phases of a personal injury case. o Opening a case o A case file is opened in Needles. The case manager will collect information related to the accident: property damage photos, police report, etc. o The case manager will set up claims with the insurance company. o The case manager may also send correspondence to the insurance companies and providers where the client has had or will receive treatment: § Letter of Representation – An LOR describes the relationship between the attorney and client; it states that the attorney has been retained to represent the client in their pursuit of a personal injury claim. It may be sent to a medical provider or an insurance company. § Letter of Protection – an LOP is a letter from the attorney to the provider guaranteeing protection of the provider’s charges. Basically, it asks the doctor to defer payment and provide medical care to the client upfront and guarantees that the provider will be paid from the client’ s recovery after the case is settled. Because the LOP acts somewhat like a credit extension, it allows patients who can’t afford healthcare or who do not have insurance to obtain medical care for the injuries they have sustained as a result of their accident. o Treatment o During the treatment phase, the client receives medical care for the injuries they sustained in their accident. o Typically, the client will receive some type of initial care on the date of their accident, usually at the ER. o Depending on their injuries, the client may receive treatment from their PCP, a chiropractor, or a physical therapist. o The client will usually receive an MRI, and if their injuries are extensive, they may receive trigger point injections or even surgery. o The treatment phase is crucial to the claims case as the settlement offered by the insurance company is largely based on the documented financial and physical damages suffered by the victim.
o To ensure that the case is progressing in the right direction during this phase, the case manager must: § Verify and order initial medical (ER, ambulance, radiology) § Contact client on a regular basis and constantly update treatment history; make sure client’s pain is improving § Verify medical providers client has seen so that all records and bills related to the case are ordered § Update Records tab and order medical records/bills as client completes appointments § Keep lawyer informed of any major treating issues as well as medical expenses incurred (updating Value tab) § Continue handling any issues with the insurance company so that the client can focus on getting better. o Waiting on Medical o The treatment phase usually lasts several months. o When the pain is gone and the client is released from treatment, the case will move into the “Waiting on Medical” stage. o During this stage, the case manager will order medical records and bills that have not been previously ordered. o The case CANNOT move forward and NO action can take place until all records and bills are received. This means that the case cannot be settled meaning: § The client isn’t getting paid. § The attorney/law firm isn’t getting paid § ARC isn’t getting paid (more on that later) o Demand o When all medical bills and records are received, the case manager can prepare the demand to the insurance company. o A demand will include the following: § A demand letter – A letter expressly stating a legal right and an amount due to reasonable compensation for injuries to person and/or property. § Property damage photos § Police report from the accident § All medical records and bills related to the accident o All of the pieces of the demand serve as documentation of damages suffered by the client and support the demand letter’s claim that the client has legal right to compensation for these damages. o The medical records and bills are the most important component of the case because they are irrefutable proof that the client has suffered physically and financially as a result of the defendant’s actions. o Settlement Negotiations o After the attorney approves the demand, it is sent to the insurance company that the claim has been filed against. o The insurance company will make a settlement offer
o The attorney will negotiate with the insurance adjuster until he or she feels that a fair settlement offer is made. o If the settlement amount cannot be reached, the case may enter litigation at which time the attorney will file a lawsuit against the insurance company o Case Disbursement o The case disbursement is when everyone gets paid. o The insurance company will send the attorney a check for the settlement amount agreed upon during the negotiation phase. o Expenses incurred and owed will be deducted from this amount: § Case expenses: postage, mileage, printing expenses, ARC, etc. § Expenses due to firm: costs paid by the firm upfront that must now be paid back, such as the fees associated with the collection of records and bills § The attorney fee will also be deducted from this amount § As previously stated, most PI attorneys work on a contingency-‐ based fee. The fee is typically 1/3 of the settlement amount recovered. o After all expenses have been disbursed from the settlement, the client will receive the remaining amount and the case will be closed. o Explain how ARC fits into all of this o By now you have realized the importance of medical records and bills in a personal injury case…if you can’t show proof that your client has suffered damages, then it is going to be impossible to get them fair compensation for said damages. o There are typically 10-‐20 records associated with a case: § EMS bill & record § ER bill & record § ER physician bill § MRI bill § Primary care physician bills & records § Chiropractor bills & records § Various treatment bills & records: trigger point injections, prescription medications, other hospital admittances, neurosurgeon, anesthesiology, etc. o The time and manpower associated with requesting, receiving, and processing these records is a high cost to the law firm. o Explain the value of ARC for our customers o ARC provides an incredibly valuable service to our customers. o When a law firm chooses to outsource their collection of records and bills to ARC, it saves the firm thousands of dollars in time and money: § The case managers’ time is freed up and they have more time to manage their clients’ treatment history and focus on quality customer service.
When a case manager does not have to spend time collecting records, it also means they can take on a higher case load which in turn generates more cash flow for the firm. § ARC cuts the firm’s overhead; they do not have to pay their case managers to collect records nor do they have to hire a staff for a records department. o Explain the importance of getting our job right o Our customers are entrusting ARC with the most important component of their cases. We make a guarantee to request, receive, and accurately process all bills and records in an average of under 30 days. Delivering on this promise is important because if we do not, it can cost the law firm and their clients a great deal of money. Getting it right and doing a good job is crucial to both the success of our customers and to us. o What is the importance of delivering the records and bills in less than 30 days? o The case manager cannot send a demand until ALL records and bills have been received. § When a case is in the “Waiting on Medical” phase, literally nothing else can be done on that case until all medical is received. § Both the client and the law firm must wait on ARC to get the records; no other action may be taken at this point. § Every day that the law firm must wait for us to get the records is another day that it will take them to get the case settled. o No one can make money or move on from that case until it is settled: § Every day that the case goes unsettled, the law firm loses money; because of the contingency-‐based fee, they do not make any money from the case until it is settled. Furthermore, they are paying their staff to continue managing this case and are not free to move onto another one § The client also cannot get paid until the case is settled. Therefore, every day that we delay is another day that the client cannot receive compensation for the damages they have suffered. o Therefore, if it takes ARC 45 days as opposed to 30 days to get just one outstanding record for a case, we have literally cost the client and the law firm 15 extra days that cannot be made up anywhere. o Explain how ARC gets paid 1) Contingency-‐Based: o Not only does it cost our customers money when we fail to deliver on our guarantee, it also costs ARC money. For some of our firms, ARC works on a contingency-‐based fee; our fee is contingent upon the records we deliver. o For every record that is requested by ARC and is received, we charge $25, and we are paid directly out of the case disbursement upon settlement. § This means that ARC is not paid upfront for our services § This is great for our customers because they are passing the cost directly onto the client §
However, for every day that we delay a case from getting settled, we are costing ourselves money § Because we do not receive payment until the end of the case, it is crucial that we provide great service and deliver on our promise to get records FAST. It is critical both for our reputation as a company and for our financial growth that we help our customers move their cases from the waiting on medical phase to the demand phase as quickly as possible. 2) Pay Upfront: o Under Construction §