HOW DOES MANAGED CARE WORK FOR YOU?

Workers' Compensation premiums and rates are based upon claims expense. Lowering your costs of claims and improving your experience will reduce your net cost. Managed Care Programs can lower your medical costs, have your workers back on the job in a timely manner, and improve employees satisfaction through professional treatment.

Greater Productivity and Employee Morale

While loss control services can assist you in preventing injuries, Managed Care can reduce the time lost by workers when an injury does occur. Prompt professional treatment and rehabilitation management saves lost wages and returns the employee to work in a timely manner. Employees have access to professionals. Additionally, employees who know their employer cares about their well being are much less likely to hire attorneys in the event of a Work Comp claim.

The net cost of your Workers' Compensation premium is a direct reflection of your claims experience. Loss control service programs are available to provide technical expertise and assistance needed to reduce the frequency and cost of injuries.

In addition, we can analyze your loss and claims history; identify accident trends; identify underlying causes of loss; develop a loss map to illustrate which areas are taking the greatest toll, and where to take action first.

Claims Specialists Line By Line

Many Insurance Brokers take the generalist approach to claims. Theodore Insurance Agency takes a specialist approach.  Our highly experienced claims staff can handle and attack your Workers' Compensation claims costs from all angles.

The Insurance Companies we represent review the accuracy and appropriateness of medical expenses, are active in steering injured workers to cost effective PPO'S, initiate return to work programs, and facilitate vocational rehabilitation and manage legal costs involved in a claim.

Classification Review

Proper risk classification is important to premium cost, as this is how your insurance premium is calculated. We can schedule a convenient meeting time to sit down with you, or one of your personnel, and review individual classifications and operations to ensure that payroll, sales and other variables are segmented for the best premium value.

Accounting and Record Keeping Assistance

The way your records are kept affects your insurance cost. Record formats can make a positive or negative impact on your premium cost. The Insurance Company auditors can review and offer suggestions to assist you in setting up your records to gain maximum advantage of manual provisions such as: state exceptions, payroll segregation, overtime rules, and other areas such as contractor contracts and costs, and secondary business operations.

Premium Audit Services That Work For You

Insurance Company auditors help you understand and manage your Workers' Compensation Insurance by:

• Ensuring that you are paying the correct premium.
• Providing you with an astute understanding of employee and other premium classifications.
• Forecasting future premium costs.
• Eliminating year end surprises.

The single most effective way to control your Workers' Compensation insurance costs is a structured medical delivery system. For such a system to succeed, however, it must be mutually beneficial for the employee, employers, and the Insurance Provider. The underlying strategy is to establish a partnership between employers, their payor, and the medical providers, thereby avoiding the adversarial atmosphere frequently associated with Workers' Compensation.

The foundation of the Managed Care Workers' Compensation Program is an extensive network of industrial clinics, specialists physicians and hospitals committed to managing costs. In jurisdictions where employers have to control employees' medical treatment for work related conditions, direction of patients to those "preferred" providers yields significant savings.

Bill Review

After treatment, the Insurance Company reviews every procedure and associated bill to ensure it complies with the prescribed fee schedule for the treatment indicated. These bill review services are provided for all forms of treatment including inpatient, physician, pharmacy, chiropractic, physical therapy, etc.

Utilization Management

The utilization review process includes prior verification of the necessity of all treatment including admission and length of stay. If inpatient care is required, length of stay and monitoring of the patient's condition throughout the hospitalization are reviewed so that the appropriate medical care services are provided.

Early Return To Work Programs

Early return to work is emphasized as a major factor in cost savings by bringing employees back to work as soon as possible. This saves substantial sums in temporary disability payments and retraining costs.

Vocational Rehabilitation

In the event of a long term catastrophic injury, the Insurance Company will make an assessment, through personal contacts with the injured worker, their family members, employer, and physician to determine rehabilitation goals and actions necessary to achieve successful resolution of the workers' medical condition.
 

Phone: 877-4-TIA-INFO (877-484-2463)
Fax: 877-FAX-4-TIA (877-329-4842)

email: theodore insurance agency