img_2460The Donna Independent School District has received the highest rating by the Texas Department of Insurance for the way it manages the district’s Workers’ Compensation Program.

Donna ISD’s Safety and Risk Management Department was recognized recently as a High-Tier Performer. The superior ranking came after the district underwent an intense six-month audit conducted by The Texas Department of Insurance Division of Workers’ Compensation (TDI-DWC). The state agency is required by law to assess the performance of entities that oversee Workers’ Comp programs along with their insurance carriers to ensure that they are in compliance with the Texas Workers’ Compensation Act and Rules.

Donna ISD and its insurance carrier Claims Administrative Services were selected for the January 1-June 30 assessment. “When we first were notified about being selected for the audit, we got a little nervous and anxious,” Director of Safety and Risk Management Angie Gonzalez De Los Rios said. “We were not sure what to expect but we got with our carrier and they gave us some information. They told us they expected nothing but a high-tier performance rating and they would help us along the way.”

Gonzalez De Los Rios said the audit was live meaning her staff was monitored daily. They were assessed on five different measures that included timely:

* payment of initial Temporary Income Benefits by the Insurance carrier,

* submission of Initial payment data via Electronic Data Interchange (EDI),

* processing of initial medical bills by the Insurance carrier,

* processing or request for reconsideration of medical bills by the Insurance carrier, and

* submission of Medical Bill Processing data via EDI.

”It was a matter of keeping organized every day to make sure we submitted all of our reports electronically to the state when they were due,” Gonzalez De Los Rios said. “If we knew we had a deadline coming up on a Friday we’d just make sure we turned it in on Thursday, instead of just waiting for that deadline to come in.”

She said the district’s new insurance carrier prepared them for the process. “When our new carrier came on board they really coached and trained us on the best practices,” Gonzalez De Los Rios said. “We implemented them right away. When the audit came, it just kind of upped the game because the processes we were asked to do we had already put in place. It was just that now they were checking us.”

TDI-DWC assessed 115 agencies from across the state. Donna ISD was among 42 that was recognized as a High Tier Performer. “Now we have a better understanding of why we do what we do,” Gonzalez De Los Rios said. “We knew we had deadlines and were required to file our reports to the state but we really never knew why. We just knew we had to do it. But participating in this process really helped us understand the reason and importance behind it.”

Gonzalez De Los Rios said that when she received word of their ranking, she immediately notified her staff. “When the unofficial email came in, I read it out loud to the staff,” Gonzalez De Los Rio said. “I said ‘guess what, the audit came back and we did really, really well.’ “

She commended her staff for a job well done. “I’m really lucky to work with the staff here because it’s non-stop with worker’s comp,” Gonzalez De Los Rios said. “They take such pride in what they do. It’s a huge responsibility to make sure that things are done right. I’m really proud of them.”

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