View this article online: https://www.claimsjournal.com/news/national/2013/04/25/227710.htm
Travelers understands the importance that employers place on effective management of the medical component of workers compensation and other property/casualty claims. With medical costs approaching 60 percent of workers compensation claim costs today and projected to increase to 67 percent by 20191, it is critical for employers, brokers, and carriers to proactively partner on timely intervention, proven return-to-work strategies, and skilled case management to avoid unnecessary delays and expense in treatment.
To assist our customers and their injured workers in achieving optimal claim and medical outcomes, Travelers is pleased to introduce its Medical Center of Excellence, an integrated set of medical management, talent, and data collection and analytic capabilities. The Medical Center of Excellence incorporates strategies such as medical bill review advancements, network management, medical and pharmacy management, fraud management and other innovative tools. The benefits of this approach to Travelers’ customers extend to all property/casualty lines of business in which medical costs drive loss costs, including workers compensation, and auto and general liability.
One of Travelers’ latest product innovations is its ConciergeClaim Nurse program (patent pending), in which a Travelers-employed registered nurse is physically located in a preferred medical clinic to facilitate access to appropriate treatment for injured employees and streamline the medical management process. ConciergeClaim Nurse is available in select markets.
The following are additional components of the Medical Center of Excellence:
• Injured worker website (mywcinfo.com) provides injured employees with access to network medical providers, statutes and regulations, and common forms.
• Investment in talent including an in-house pharmacist and additional physicians to develop innovative medical protocols.
• Medical specialists who assist in individual claim management and in driving the development of medical management strategies.
• Nurse case managers (in-house RNs) to help design quality, cost-effective treatment plans that enable injured employees to return to work as soon as possible.
• Medical data warehouse containing millions of pieces of detailed medical information.
• Predictive modeling capabilities which support the development of claim management tools, including a patented nurse triage model and a chronic pain intervention program.
• Not-for-profit modified duty program that places injured employees temporarily in roles at approved non-profit organizations, allowing them to stay active as they recover.
• Industry-leading focus on medical fraud for the benefit of our customers.
• Specialized Medical Audit and Review Team (“SMART”) reviews a portion of medical bills to identify savings opportunities that an automated bill review system cannot catch.
“Travelers’ wealth of medical and loss data, combined with our in-house medical talent and analytic capabilities, allows us to develop proactive strategies for managing injured workers’ safe and timely return to work,” explains Jim Wucherpfennig, vice Ppesident, workers compensation, claim. “We know that timely intervention is critical in providing superior claim management, and our proprietary predictive models help us deploy the right resources, with the right tools and knowledge, at the right time throughout the life of a claim.”
Source: Travelers