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Cost Reduction-RTW


Integral to any Return – To - Work Program is a comprehensive and effective case management process. The CompMed Partnership Return - to-Work program incorporates a time tested case management function managed by a staff of professionals with a demonstrated extremely effective track record at managing the delivery of healthcare to injured workers where employee outcomes and cost reductions are maximized.

The CompMed Partnership offers RTW in a comprehensive program which not only involves comprehensive case management but also includes job function analysis, safety reviews and which requires participation by the employer in offering a light duty component. CMA Partnership also coordinates with clients claims examination staff so that required medical treatment is obtained as timely as possible which is critical to the effectiveness of the program.

This program can be offered on a risk sharing basis or priced traditionally using hourly or case based rates. For clients not capable of investing in or not interested in the comprehensive program CMA Partnership offers traditional case management through telephonic or on-site processing.

 

Employer Benefits with CompMed Partnerships


  • Direct control over workers’ comp & disability expenses
  • Decreased lost work days
  • Reduced medical & indemnity costs
  • Enhanced claims management
  • Support for Injury Prevention & Safety Programs
  • High employee satisfaction
  • Fewer litigated claims

Employer Experience


Reductions in:

  • Medical Expense (30 to 40%)
  • Lost Time Cases
  • Indemnity Expense (50 to 80%)
  • Reserve Setting
  • Indirect Cost

Why CompMed Partnerships Are Successful


Work Site Knowledge

  • Work site walk through done with all new customers
  • Job Assessments conducted documenting physical requirements of each job, information shared with providers to assist in Return-To-Work
  • Decisions and Recommendations made for ergonomic concerns

24/7 Point of Entry CompMed Care Management

  • Claimants call 1-800 # prior to seeking care
  • Speak to “live” Nurse Case Manager 24/7
  • Intake history completed at time of initial call
  • Arrangements made for immediate care

Immediate Medical Care

  • Offer network provider of choice
  • Notify provider office of patient visit
  • Reminder to MD Office to call or fax
  • Patient Management Form

Patient Management Form

  • Critical for Case Management and timeliness of care
  • Major functions:
    • Diagnosis
    • Degree of Disability
    • Return To Work Capabilities
    • Request for Authorization

Same Day Authorizations No Delays in Treatment

  • Provider requests authorization on Patient Management Form
  • Nurse Case Manager collaborates with claims administrator recommending authorization, usually granted same day
  • Arrangement made for testing, treatment within 24 to 48 hours (PT, MRI, etc.)

Timely Communication

  • No “Black Holes”
  • Three-way communication after each patient visit between Case Manager, Claims Administrator, and the Employer to address expected recovery
  • Discussion with Employer/Supervisor of work restrictions if transitional work assignment is necessary

Engaged Provider Network

  • Providers are expected to use "best practice" guidelines for care
  • Cooperate in the completion and return of the Patient Management Form
  • Specialist agree to appointment - *Urgent Need - Within One Business Day *Non-urgent Need - Within Five Business Days

Steps to a Successful Return To Work Program

  • A corporate policy needs to be in place that reflects the company’s commitment to RTW
  • Educate employees and supervisors about the benefits of participating in the RTW Program
  • Identify meaningful and productive transitional work opportunities.
  • The Program needs to be flexible so it can accommodate a variety of situations.

Benefit of RTW Program for Employers

  • Returns an experienced employee in a safe and timely manner
  • Reduces the cost of training replacement
  • Maintains a good employer/employee relationship
  • Demonstrates to all workers that they are valued employees
  • Save money through “loss prevention”

Support for Injury Prevention & Safety Initiatives

  • Provide meaningful trends data-similar injuries, same job task or equipment used, same department, not using PPE
  • Active member of Safety Committee
  • Support for work-site reintegration
  • Ergonomic recommendation

Employee Benefit of RTW

 

  • Impact of financial uncertainty on the employee and their family and concerns about their future with the firm are reduced
  • Recovery is more complete
  • A sense of attachment with their co-workers can be maintained

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