PreventivePLUS

Workplace Injury & Illness

1

Workers Compensation Management & Care Coordination Team

We understand that your employee’s health and productivity on the job are critical to the success of all organizations. Proactive management and our extensive experience, with over 20 years in providing management services for workers compensation cases, allows us to bring your employee’s back to the work place faster than most. Thorough initial examinations, continual follow-up with the member, their treating physicians, the company, and adjuster, constant modification to the treatment plan and immediate actions plans, are just some of the values that your members will experience when under our watch.

Goals of Our Workers Compensation Management:

Facilitate productive interaction between the injured member, the company, and the adjuster.

• Provide timely and detailed status reports to the designated employee representative
• Monitor the members progress closely, modifying the treatment plan as necessary
• Being aware of utilizing first aid services whenever possible
• Maximize employee productivity
• Coordinate and structure a network of Urgent Care Centers to treat most of your needs
• Provide the oversight on these clinics to assure quality and proper reporting
• Improve patient safety and reduce errors Increase quality of care by utilizing health information technology
• Generate total health care cost savings through: decreased absenteeism & presenteeism; reduced over utilization of services, reduce duplication of services; all while improving the overall health of the group, reducing the need for services.

Role of the Patient Advocate:

Facilitate productive interactions between the injured member, their treating providers, the company, and the adjuster

• Review of medical records and claims
• Patient education about specific health issues and injuries
• Consult with current providers on your case to resolve issues or road blocks with the healthcare plan and/or difficulty in diagnosis
• Monitor recommended treatment plan and related testing, drug therapy, and procedures
• Ensure timely and appropriate testing and therapies are approved and initiated as needed

Role of the care team:

• Coordination of medical records
• Assistance in setting timely and appropriate referral/second opinions
• Compression of the time frame of the workers’ health issue to return them to health rapidly and back to the workplace as soon as possible

Cost: Based on an hourly fee schedule broken into 3 tiers: MD, RN, Staff

The billable time will be based on time spent to report on each members visit, consulting with the members care team, and care coordination for the member. The remaining benefits are included in the program.