It’s now even more important for employers to notify their claims adjuster immediately if an employee requests a non-emergency surgery.
Minnesota workers’ compensation law changed recently to allow an employee to notify their employer directly of a request for non-emergency surgery. Once notice has been given, the employer or insurer has seven days to give a response to the request. In a previous version of the law, such requests had to be directed to the insurer by the health care provider.
Legal options available to employers and insurers for response include approving or denying the surgery, requesting additional information or a second opinion, or requesting an independent medical examination (IME).
Kirsten Peterson has been a Medical Support Representative at SFM for two years, and in the workers’ compensation industry for 15 years. Kirsten is part of SFM’s in-house bill review team. We asked Peterson to share a little bit about her background and her role.
How did you get into workers’ compensation? I just kind of fell into it by getting a temp job at a small workers’ compensation third-party administrator. I later got a job with a large pharmacy benefits manager. That’s where I learned a lot about medication and authorization and different rules for different states regarding medication. I still use that knowledge to this day, which is really cool. It’s kind of funny how it comes full circle.
How did you end up at SFM? When I moved back to Minnesota, I made a list of the insurance carriers that were local and who had the nicest adjusters and SFM was at the top.
How would you describe your role in a nutshell? A lot of what we do is processing medical bills, but a lot of people don’t know that we also educate medical providers to make sure they are billing us correctly and that we’re also paying them correctly. We also work closely with different state agencies to make sure that we’re following state-specific guidelines and rules. When we’re reviewing medical bills, we’re looking to make sure the bill relates to our injury. Sometimes we’re even identifying additional body parts or red flags in the medical records and passing that information on to the adjuster. They appreciate having us as their second set of eyes.
How is SFM different from other organizations you’ve worked for? There’s a big sense of family, which I really love. Everyone is super kind, super friendly, super nice, very, very helpful. I love how close knit everyone is and you make relationships with people as you get to know them. We have a big focus on collaboration and learning from one another and teaching one another. I love having the opportunity to teach people on my team. Everyone’s feedback is heard and is welcomed. I work for an amazing team. Everyone’s super supportive. My boss is amazing. I love it a lot.
What do you like about your job? I love that it’s completely different every single day. We have our basic set of tasks, but how you approach a bill is different from bill to bill and even claim to claim. I love provider phone calls because they keep us on our toes. Sometimes it’s a simple phone call wanting to know if the bill was received, and sometimes it’s a lot more complex.
What’s most challenging about your job? There’s a lot of different state rules and regulations, so as we branch out into new states – which is really awesome and exciting – there’re new things that we have to learn, so we have to do the research. We have to reach out to other departments of labor and industry and make sure that we’re doing things appropriately, so that’s where it can get a little bit challenging.
What words of wisdom do you have for employers? Make sure injured workers know to give our billing information right away when they go to medical appointments. If they don’t have a claim number yet, that’s OK. At least give our mailing address. That’ll ensure a smooth billing process, and they won’t get any unexpected bills sent to them.
SFM’s Companion magazine will be delivered via email only starting with the January 2024 edition.
“As more and more communication moves to electronic channels in many of the workplaces we serve, we felt the time was right to make this change,” said Vice President and Chief Communications Officer Andy Gebhard. “Discontinuing our print edition will allow us to place more focus on our online resources, and operate in a more environmentally friendly way.”
SFM will continue to send out the emailed edition of the Companion as it has for the past several years. Going forward, recipients of the electronic version will see no immediate changes.
In addition to the Companion email newsletter, SFM policyholders have on-demand access to a wealth of articles, downloadable resources, and videos covering a variety of workers’ compensation-related topics at sfmic.com.
Fifteen years after the SFM Foundation began their mission to help make college affordable for students affected by work injuries, they’ve granted 232 scholarships totaling $3.7 million.
This includes $502,000 awarded to 16 new recipients announced in May. Six of these students are from Iowa and 10 are from Minnesota.
Over 125 scholarship recipients have graduated since the SFM Foundation’s inception in 2008, and there are currently 72 active scholarships. Scholarships are awarded regardless of the workers’ compensation insurer involved in the claim.
Thanks to the generous support of event sponsors and donors, the Foundation has been able to reach these families in need for a decade and a half.
The Foundation’s golf fundraisers are the primary source of fundraising for their scholarship fund, and 2023 was no exception. The Minnesota golf event has become one of the largest charity golf tournaments in the state. This year’s event on June 12 raised an astounding $125,000 for the scholarship program. The Iowa golf outing is a newer event and continues to grow each year. This year’s event on May 22 raised $45,000 for scholarships.
The Foundation is always on the lookout for eligible scholarship candidates. If you know of a family who would qualify for an SFM Foundation scholarship, please direct them to sfmfoundation.com/apply .
About the SFM Foundation
The SFM Foundation provides scholarships for students whose parents were seriously injured or killed while working for Minnesota or Iowa employers. SFM Foundation is an affiliate of Kids’ Chance of America in Iowa and Minnesota and is also known as Kids’ Chance of Iowa.To learn more about the cause, visit sfmfoundation.com .
Registration is now open for the SFM Foundation 2023 Minnesota and Iowa “Golfing for Scholarships” fundraisers. The Foundation’s golf events are the biggest fundraisers of the year and pay for most of their multi-year scholarships.
Events will be held on the following dates:
Minnesota golf event – Monday, June 12, 2023 at Prestwick Golf Club in Woodbury, Minnesota
Iowa golf event – Monday, May 22, 2023 at Hyperion Field Club in Johnston, Iowa
Participate in the event by sponsoring, golfing or both. Sponsorship opportunities are available ranging from $750 to $10,000.
Space at both events is limited, so register early to secure a spot.
Funds raised at these events go toward scholarships for students whose parents were seriously injured or killed while working for Minnesota or Iowa employers.
The SFM Foundation was created in 2008 by SFM Companies, a regional workers’ compensation insurance group headquartered in Bloomington, Minnesota. SFM Foundation is dedicated to easing the burdens on families affected by workplace accidents. Since its inception, the Foundation has awarded 216 scholarships totaling $3.2 million. For more information, visit sfmfoundation.com .
When you use a third-party service to pay your workers’ compensation premium, your payment can be delayed. If this causes a late payment, it can start the policy cancellation process.
To avoid delays, we recommend paying bills to SFM directly through the SFM website. When you pay on our website with your bank account, any installment fees are waived, and you can set up AutoPay so future bills are paid automatically on the due date.
SFM is not affiliated with any third-party bill paying services.
Wisconsin-based Loss Prevention Specialist Carl Gruber received SFM’s most prestigious service excellence award for 2022.
The Richard J. Marshik Service Excellence Award goes to one SFM employee annually who exemplifies the level of service that has become SFM’s hallmark.
Gruber’s passion and dedication to providing incredible service to policyholders, workers and his team helped earn him the award. He regularly goes above and beyond to ensure that all customers are 100% satisfied, focuses on building and fostering solid relationships, takes a hands-on approach, regularly offers coworkers assistance, communicates well with customers of all types, and has a positive personality that is “infectious.”
Gruber’s job is to help SFM policyholders reduce or eliminate workplace injuries. He offers each customer a truly unique experience that focuses on the employer’s individual risks. Policyholders rave about how easy he is to work with and how he’s able to motivate employees to work safely. His warm, enduring and sincere nature tears down any barriers or apprehensions. People take precedence over policy, resulting in a safer work environment for policyholders.
“Not a working day goes by where Carl doesn’t make me smile or feel appreciated,” said one of his award nominators. “The Dick Marshik Award is the ultimate recognition an SFM employee can receive. I don’t know another SFM employee that deserves such recognition more than my coworker and good friend, Carl Gruber.”
Earlier this year, SFM established a new scholarship program designed to identify and support future leaders and introduce them to rewarding careers in the insurance industry. The Bob Lund Scholarship is named for SFM’s former CEO, who is widely known for his service to the field of insurance and his continuing passion for making the world a better place.
The group of SFM employees behind this effort, known as the Insuring the Future Committee, chose to partner with Wallin Education Partners . This Minnesota-based nonprofit has an established history of connecting students in need with the support they need to succeed in college and beyond. The Wallin scholarship program is committed to supporting students from historically underserved communities and eliminating barriers for groups that are underrepresented in business leadership roles (see page 100 of the 2022 Wallin Scholarship Yearbook where the SFM program is detailed).
“We decided to partner with Wallin because not only do they facilitate the scholarship and help us find a student, but they also provide support to students in the program throughout their college career,” said Insuring the Future Committee chair Carl Gruber. “They’re committed to supporting their students and helping them succeed.”
Meet the first Bob Lund Scholar
The inaugural Bob Lund Scholarship recipient, Van Nguyen, started this fall at the University of Minnesota – Twin Cities as a first-year student.
The major Nguyen has chosen to pursue is Finance, Operations Management. She graduated from Robbinsdale Cooper High School in 2022, having distinguished herself through both academics and extracurricular achievements. The plan is to award Nguyen a scholarship through all four years of school, as long as she stays compliant with the program’s requirements.
In her scholarship application, Nguyen shared: “I believe that a successful college experience would be being able to find out who you are as you’re developing so many new skills and academic enrichments while learning about your interests.”
In addition to sponsoring Nguyen, the Insuring the Future Committee plans to support a new student each year, aiming to provide scholarships for four students at a time. The committee is also working on starting an internship open to Wallin Scholars.
The SFM Foundation was featured on the November 9 edition of the KARE 11 “Communities that KARE” segment.
SFM Foundation Scholarship Director Debra Zorn was interviewed along with scholarship recipients Haley and Mason Rinzel and their parents.
KARE 11’s video and article showcase how the SFM Foundation changes lives and how their scholarships personally impacted the Rinzel family after Haley and Mason’s father, Greg, was injured in the line of duty as a Cottage Grove police officer.
“We are absolutely elated to have been featured by KARE 11,” said SFM Foundation President Linda Williams. “We are so grateful to KARE 11 for helping us spread the word about the important work we do so we can help more deserving families.”
The SFM Foundation was created in 2008 by SFM Companies, a regional workers’ compensation insurance group headquartered in Bloomington, Minnesota. SFM Foundation is dedicated to easing the burdens on families affected by workplace accidents. Since its inception, the Foundation has awarded 187 scholarships totaling $2.4 million. For more information, visit sfmfoundation.com .
Injured workers covered by SFM now have 24/7 digital access to their claim information through SFM’s website.
Through a new self-service tool called SFM Claim Connection, workers with SFM claims can access claim details, review payments, download forms and set up text alerts to be notified of payment activity.
“This is the latest development in our ongoing initiative to improve the claim experience for the workers we serve,” said Steve Sandilla, SFM’s Senior Vice President of Strategic Business Operations. “We’re striving to eliminate barriers for the employees we insure, and this tool gives them a valuable new way to access critical information about their claims.”
Optimized for mobile devices
The system was designed with mobile users in mind, as we recognize that a growing percentage of users prefer to access this kind of information on their phones. Smartphone users can access all the same information that’s available on the desktop version. The application even includes a mobile-friendly insurance ID card that workers can take with them to medical appointments.
Empowering workers with information
“Equipping injured workers with the right information at the right time makes their lives easier,” Sandilla said. “We’ve always worked hard to empower our customers with reliable answers, and now we have a convenient new tool to help us deliver on that promise.”
The inaugural Bob Lund Scholarship recipient, Van Nguyen, started this fall at the University of Minnesota – Twin Cities as a first-year student.