Medical cost containment program is an end to end pharmaceutical cost containment programs which puts the patient first while reducing the cost of settlement in large loss workers comp claims. Today, businesses are challenged to control workers compensation cost and improve the income. Only framing an effective cost containment strategy focuses on different areas and provides possible tricks to avoid any mess.
Using comprehensive and well-coordinated medical cost containment strategies helps you to combat multiple lines of cost escalation. Incorporate the following useful options to your medical cost containment strategies while seeking improvements at your company.
Medical Provider Network
Medical provider network is a combined group of the most experienced workers’ comp physicians, doctors, hospitals and specialized providers who have a prearranged relationship with the company to treat employees who are injured on the job. They deliver consistent quality care and work closely while minimizing paperwork and treatment time and maximizing the results of quick, effective care. The major benefits of instituting a medical provider network are:
* Fewer lost workdays
* Lower medical costs
* Lower litigation rates
Nurse Case Management
Nurse case management requires an active coordination of medical services and communication among the injured employee, employer and physician. The nurse case managers play a major role in improving the patient’s outcome and have deep experience in managing catastrophic and complex injuries. They also keep the employer and the claim representative well-updated on the physical improvement of the injured employee and his ability to return to work.
Rehabilitation Networks
Rehabilitation networks are destined to offer specialized care for helping injured people recover from specific injuries. Like medical provider network, they also play a major role in stabilizing the injured person’s medical condition and maximize the medical outcome.
Utilization Review
Nowadays, utilization review is an integral part of most public and private health plans and is associated with a reduction in bed days and growing hospital costs. Utilization review is considered as the primary cost prevention tool and includes both precertification reviews and concurrent reviews. The process involved in utilization review also includes:
* Guiding patients to cost effective facilities
* Referral co-ordination
* Managing hospital admission and medical appointments
* Pre-certification
* Monitoring patient’s ongoing treatment process
* Planning patient discharge
* Coordinating follow-up appointments and more.
Utilization review managers also act as liaisons between insurance companies, service providers and the injured employee.
Chronic Pain Management
Chronic pain has a huge impact on the life of the injured worker in both monetary and personal fronts. Using data mining and virtual online “check-ins” to monitor and evaluate the physical, psychological and social impacts on the injured employee. This process of evaluation helps in reducing the impact of chronic pain and improves employee health.
Establishing these standards help companies to easily manage their complex claims and ensure the best possible medical outcomes for injured workers.
ANS Solutions, LLC, the fastest growing medical cost containment companies in the USA puts forward a comprehensive suite of programs to minimize the cost of settlement in large loss workers comp claims. Visit http://ans-solutions.com/ for more information.
ANS Solutions, LLC 