Managed Care

Keeping Claims Cost About the Claim

Andrea Kiener
Keeping Claims Cost About the Claim
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Published on Jul 22
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Do you have someone watching out for underlying conditions sneaking its way into your claim? At times it seems like conditions are included in a workers’ compensation claim that shouldn’t be. It is important to contain the claim’s cost to the actual claim, and not conditions outside the accident.

Proactive Claims Management

There was an employee that sustained a shoulder strain in a motor vehicle accident while on the job. This employee, however, had a degenerative shoulder condition prior to the accident. The RN Nurse Case Manager assigned to this case, saw the degenerative condition and proactively discussed it with the employee’s physician of record. The physician then determined the condition wasn’t related to the cause of the injury, and that the treatment for the shoulder condition should remain separate from the claim. After the injured employee was informed of this, he quickly and safely returned to work at full capacity.

It is in cases like this that proactive claims management can save medical costs, potential lost time and premium dollars. That is why it’s important to have a Managed Care Organization you trust.

Know your partner

An MCO partner like Sheakley UniComp can guide you and your workers through the confusing world of workers’ compensation. We can help you understand more about the BWC and its processes. Your MCO serves both the best interests of your company and your employees by keeping your workers’ compensation costs down and returning injured employees to work quickly.

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