Why We’ve Been Successful
- 24 Hr. “Point of Entry” Care Management
- Immediate Medical Care, Same Day Authorizations
- Engaged Provider Network
- Timely Communication
- Work Site Knowledge
- Effective Return To Work
- Support for Injury Prevention & Safety Initiatives
24/7 Point of Entry Care Management
- Claimants are required to call our 800# prior to seeking treatment unless their injury is “life threatening”
- Nurse Case Managers are available 24/7 to perform intakes and arrange immediate medical care and to educate provider of visit and opportunity for Return to Work
- Nurse Case Managers perform telephonic and field case management, often attending appointments with claimants when requested.
Same Day Authorizations No Delays in Treatment
- Provider requests for authorization managed on the same day received
- Nurse Case Managers make recommendations and requests to Claim Adjustor based on the NYS WCB Medical Treatment Guidelines and provide medical documentation to support request
- Arrangement made for testing, treatment within 24 to 48 hours (PT, MRI, etc.)
Engaged WC PPO Network
- Providers are expected to use "best practice" PPO Practice Parameters and NYS WCB Medical Treatment guidelines for care
- Providers are educated and encouraged to define capabilities to allow transitional or non-restricted return to regular job duties
- Cooperate in the completion and return of the Patient Management Record
No “Black Holes”
- Full circle communication with the team after each claimant visit; Employee, Nurse Case Manager, Medical Provider Claim Adjustor, and the Employer to address expected recovery
- Discussion with Employee, Employer, and Supervisor of work restrictions if a transitional work assignment is necessary.
Work Site Knowledge and Effective Return To Work
- Prior to Employer service start-up, the NCM performs Job Assessments at worksite and documents essential functions of each job.
- The information is stored in our database for future use in Return To Work decisions
- NCM collaborates with the Employer to identify transitional work opportunities
Support for Injury Prevention & Safety Initiatives
- Provide meaningful trends data: i.e. Similar injuries, same job task or equipment used, same department, not using personal protection equipment.
- Active member of Safety Committee as requested.
- Work-site reintegration by Case Manager if needed.
- Ergonomic evaluations & training from on staff Physical Therapist / Industrial Specialist are available.