ASCIP
Home Workers’ Compensation

Workers’ Compensation

Why ASCIP Workers' Compensation

We Are Your Experts. ASCIP offers expert in-house claims oversight to partner with school district members, ensuring that precious school resources are being smartly utilized to provide the required benefits with an emphasis on resolution of issues including return-to-work, litigation strategies, medical management and managed care. Because of this expert oversight, the ASCIP Workers’ Compensation program is financially strong with very competitive rates that have allowed our membership to enjoy year-after-year rebates, ultimately putting insurance dollars back into the classroom.

We Help Your Expertise. In partnership with our school district members, ASCIP is able to provide training to district employees from frontline staff to leadership using a broad curriculum that includes Industrial Accident & Illness Leave, various workers’ compensation subjects, regulatory concerns (Cal/OSHA, FEHA, ADA) as well as accident investigation and safety.

We Partner With Claims Experts. We offer to our school district members the choice of two Third Party Administrators, Athens Administrators or Sedgwick, for life-of-claim handling with defined goals and objectives fueling positive claim outcomes as evidenced by constant data analysis.

Member Delight is the ASCIP difference. Anyone can provide coverage and process claims. Your ASCIP claim professionals have years of experience taking on an active role in the management of our school district member’s workers’ compensation program in an effort to make their work life easier. 

Contacts

Nidra Kumaradas
Executive Director of Workers’ Compensation

Phone: 562-677-2016
Send an Email

For General Program
and Claims

Claims Management Services

Claim Handling Expertise. The ASCIP workers’ compensation claims management philosophy is simple. Resolve claim issues effectively in an effort to close claims. Our Third Party Administrator partners have a knowledgeable indemnity adjusting staff, which is assigned by the school district. The claim team structure also features specialty handling areas such as Claim Resolution Specialists, Future Medical Adjuster, and Medical Only Adjuster to enhance the expert skill sets our assigned indemnity adjusters provide.

School District Experience. All claims handling is not created equally. ASCIP has partnered with Third Party Administrators who have proven track records when it comes to the nuances of handling school district claims. Whether utilizing the Education Code for benefit administration or understanding how schools operate, our dedicated claims team thoroughly investigates claims and manages them through conclusion while navigating the unique nature of school districts.

We Help You See the Big Picture. ASCIP looks for opportunities for global resolution of claims to avoid workers’ compensation claims from becoming costly employment liability claims. This is accomplished through the workers’ compensation and property and liability claim teams working cohesively with the school district members for the best possible outcome. Communication is key, and we help to facilitate these important discussions.

Choice of Administrator

  • Athens Administrators; or
  • Sedgwick

Third-Party Administrator (TPA)

Athens Administrators

Phone:  (925) 826-1112
Email: Email Athens
www.athensadmin.com

Sedgwick

Phone: 909-942-5464
Mobile: 714-470-3705
Email: Email Sedgwick
www.sedgwick.com

ASCIP’s Claims Administration Services include:

  • Dedicated claims team
  • In-house technical claims professionals
  • Indemnity Adjuster: Caseloads of 125 files maximum
  • “Day of Injury” triage services
  • Regular file reviews
  • Viewing access to claims system
  • Medical Provider Network (MPN)
  • And much more!

Claims Reporting Instructions

Athens

  1. Instruct the employee to immediately contact Company Nurse by calling (888) 770-0929, (Valley Insurance Program members please call (877) 854-6877).
  2. Within 24 hours of knowledge of injury, provide the injured or ill employee with:
    1. DWC-1 Claim Form
    2. MPN Informational Pamphlet
    3. Pharmacy First Fill Flyer
    4. Receipt of Workers’ Compensation Information Form. Once the employee returns the DWC-1 Claim Form, the employer must complete the employer section at the bottom of the form and return a copy to the claims administrator.
  3. Complete the Employer’s Report of Occupational Injury or Illness (Form 5020) online.
  4. Serious injuries/illnesses must be reported to Cal/OSHA within 8 hours of knowledge.
Report Athens Claims

Sedgwick

  1. Instruct the employee to immediately contact Company Nurse by calling (888) 770-0929
  2. Within 24 hours of knowledge of injury, provide the injured or ill employee with:
    1. DWC-1 Claim Form
    2. MPN Informational Pamphlet
    3. Pharmacy First Fill Flyer
    4. Receipt of Workers’ Compensation Information Form. Once the employee returns the DWC-1 Claim Form, the employer must complete the employer section at the bottom of the form and return a copy to the claims administrator.
  3. Complete the Employer’s Report of Occupational Injury or Illness (Form 5020) online.
  4. Serious injuries/illnesses must be reported to Cal/OSHA within 8 hours of knowledge.
Report Sedgwick Claims

Features & Enhancement

Medical Resources

Unique to any medical management program, ASCIP actively manages and continuously audits all its medical management products, both from an outcome and cost perspective. Using customized metrics and the highest standards for audit and reporting, ASCIP’s medical bill review program, pharmacy benefit manager (PBM), utilization review (UR), and case management resources are managed to ensure optimal performance, outcomes and costs. ASCIP reviews monthly product “dashboards” customized for each service line that enable us to not only gauge performance, but quickly identify variances, then immediately address those outliers. The ASCIP medical management program is the benchmark in the industry.  For additional medical resources, contact ASCIP, Shawn Potter, (562) 404-8029
  • Clinic changes
  • Profile updates
  • Inquiries requiring escalation and/or medical oversight review
  • Ancillary provider issues (diagnostic testing, physical therapy, prescriptions)
  • Company Nurse

Medical Provider Network (MPN)

Member school district employees access ASCIP’s actively managed Medical Provider Network (MPN) through our two Third Party Administrators, Sedgwick and Athens. Unique to the ASCIP MPN program is our multi-party provider review process and continuous metric driven assessments, which drive optimal clinical and financial outcomes for our members. Additionally, ASCIP’s MPN cost structure is likely the lowest in the industry, allowing us to pass cost savings to our members.

Athens/MEDEX

Sedgwick/Wellcomp

Return to Work

In partnership with our Third Party Administrators and with availability of a renowned return-to-work vendor, ASCIP works towards innovative solutions to disability management issues. Fully utilizing all available tools and actively engaging with members helps drive cost containment and optimization of school district resources.

  • ASCIP, Shawn Potter, (562) 404-8029

Forms & Posters

Athens Administrators

Forms
Posters

Sedgwick

Forms
Posters

Resources

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