Presentation Title
The Workers' Compensation Process, BWC Panel
 
About the Presentation

This session will review the Workers’ Compensation process overseen by the Bureau. Topics will include the WC claim process including electronic data interchange claim filing (EDI), health care services procedures including medical fee review, medical treatment review, impairment rating evaluations, and the medical access study. Time will be allocated for an open Q&A session with Bureau leadership. 

 
Presenter
Patricia Clemens, Chief of Health Care Services Review Division, Bureau of Workers' Compensation
 
Presenter Biography

Patricia Clemens is the Chief of the Health Care Services Review Division for the Pennsylvania Bureau of Workers Compensation.  Patricia is a registered nurse whose clinical experience spans a variety of care settings including time as a workers’ compensation case manager.  Patricia joined the Commonwealth in 2008 to oversee quality and utilization review in the Children’s Health Insurance Program.  In 2011 she joined the Bureau of Workers’ Compensation (BWC) as a medical fee review nurse.  In 2015 she worked as a supervisor for the Medical Assistance Bureau of Program Integrity before returning to BWC in her current position in 2016.  In addition to her BSN, Patricia holds a Masters in Health Informatics, is a certified professional coder through AAPC, and has earned her Health Care Quality and Management certification through the American Board of Quality Assurance and Utilization Review Physicians.

 
Presenter
Scott G. Weiant, Director, Bureau of Workers' Compensation  
Presenter Biography

Scott G. Weiant, Director, PA. Bureau of Workers’ Compensation; In his role, Scott maintains oversight responsibilities for the administration of Pennsylvania's Bureau of Workers' Compensation. Rresponsibilities include providing leadership for the Health & Safety Division, Claims Management Division, Health Care Services Division, Self-Insurance Division, Administration Division, Compliance Section and Uninsured Employers Guarantee Fund Section. Prior to his July 2015 appointment as BWC Director, Weiant occupied numerous leadership positions within the bureau. In 2002 he brought 22 years of private industry experience to the commonwealth when he joined the bureau’s Health & Safety Division. Weiant went on to work in numerous leadership positions within the Commonwealth, eventually Chief of the Health & Safety Division.

During his tenure as division chief, Weiant provided leadership throughout the development of WCAIS and the launch of the Health & Safety Division’s outreach and training resource, PATHS. In August 2014 he was appointed to the newly-created position of assistant director, directly overseeing the operations of the Claims Management Division, the Health & Safety Division, the Compliance Section, and the Uninsured Employers Guaranty Fund.

Scott is a current member of the Governor’s Occupational Safety & Health Conference Committee, Governor’s Award for Safety Excellence Review Committee, the Governor’s Occupational Safety & Health Conference Program Committee, and WCAIS Development Team.
 
Presenter
Eric G. Preputnick, Deputy Chief Counsel with the Department of Labor and Industry’s Office of Chief Counsel, Workers’ Compensation Division
 
Presenter Biography
Eric G. Preputnick is the Deputy Chief Counsel with the Department of Labor and Industry’s Office of Chief Counsel, Workers’ Compensation Division.  He has been with the Department since 1997.  Currently, in his role as Deputy Chief Counsel, Eric is the lead attorney and supervisor for the Bureau of Workers' Compensation's legal office.  Prior to this position, Eric held the role of assistant counsel and was responsible for handling administrative litigation across the state involving the bureau’s various statutory funds, including the Uninsured Employers Guaranty Fund, as well as civil collection matters and Section 305 criminal prosecutions against uninsured employers.  Eric received his B.S. degree from Susquehanna University and his J.D. from Cornell Law School.  
Presenter
Harte Pricer, Manager of the EDI Section, Claims Management Division of the PA Bureau of Workers’ Compensation  
Presenter Biography
Harte Pricer is the manager of the EDI Section of the Claims Management Division of the PA Bureau of Workers’ Compensation and the chair of the PA EDI committee. Harte iscurrently an active member of the IAIAIBC EDI Claims, Claims Implementation, and Systems committees and was recently granted a seat on the IAIABC EDI Council on behalf of Pennsylvania. Harte was recently awarded the IAIABC NextGen award and has since become part of the NextGen Award Selection Committee. Since the inception of WCAIS, Harte has been a major contributor to thedevelopment, testing, and implementation of program area requirements for the subsequent system improvements.  Harte had an instrumental role on the team that designed the PA EDI Forms Solution program,which was released in September 2016.  This complex Forms Solution system is one-of-a-kind, automatically generating forms triggered by various EDI transactions for insurers who used to have to submit them manually.  The implementation of this system has eliminated the submission to the bureau of approximately 300,000 paper forms annually, saving PA stakeholders time & money.