Communication is Key to Managing Work Comp Claims

By Danielle Troyer

Workers’ compensation claims involve numerous parties including physicians, surgeons, therapists, case manager, employers, adjusters, and most importantly the employee. To efficiently and appropriately manage work comp claims, a relationship needs to be built and maintained with each of these parties. Constant communication should be taking place during the employee’s course of treatment.

The case manager is the heart of these relationships. They are skilled in facilitating the patient’s care to maximize efficiency which not only benefits the patient, but all parties involved. They are the key to effective communication.

With this said, all other parties still have their own responsibilities. Employees must report the injury accurately and promptly. Employers must investigate and report this to their carrier while allowing the employee access to timely medical care. Physicians must provide quality medical care and should be issuing and updating work status in a timely manner. Insurance adjusters or case managers should be reviewing the claim and giving appropriate treatment authorizations. Case managers must ensure the patient understands their treatment options and questions are addressed while facilitating communication between everyone involved. These and other responsibilities involved are dependent upon effective communication in order for the process to flow smoothly.

The professionals at The Centre for Working Hands are dedicated to upholding their responsibility and maintaining these relationships. Employers, insurance adjusters, and case managers are sent copies of updated work restrictions and physician visit updates after each visit. Authorization is requested for everything outside of physician office visits including, but not limited to, therapy, surgery, referrals, etc. The therapists and physicians are available for any additional questions that may come up in between visits and are easy to contact when clarification is needed.

Consider the relationship you have with your employees, employers, case managers, insurance adjusters and providers. Is communication taking place as it should be? An improvement in this area will help your entire workers’ compensation process develop. You will see improved relationships, greater efficiency and ultimately a natural cost reduction in the overall care while maintaining the high quality one should expect.