#8 Solutions at the root cause of claim problems
The formulas, the tools and the roadmap to repeatable results
Your biggest cost driver?
It's not opioids, depression, diabetes, litigation, surgery, obesity, hospitalization, substance abuse, smoking,hypertension, physician-dispensing or compounding.
Those are confounding factors. They make the problem worse (much worse).
The root of the problem is time away from work.
The longer the absence, the higher the cost. (Thank you, Dr. Obvious). Stay with me...
The interaction between duration and cost is non-linear; it's exponential. (It turns up like a hockey stick).
So what drives duration?
Claim risk assessment using diagnoses and demographics, sure, but three simple variables all within your sphere of influence play a major role-
1) Medical treatment
2) Availability of modified duty
3) Getting a release to work
Take a series of steps, as simple as 1, 2, 3.
Be a champion of modified duty. Educate clients and claimants that it is the single most important thing to keeping claims from going off the track.
Identify high risk claims early, and get the right care in place quicky. The wrong care, or delays in delivering and approving the right care, will only prolong duration.
Then set and share expectations for best practice RTW, and push it out for sign-off from the physician.
Be your best.
Problem-solving is a mix of knowledge and action. Find a process that works, and wash, rinse, repeat.
At ODG, we provide the formulas, the tools, and the training to be a problem-solver every day.
The world needs problem-solvers.
Empower your people with premium tools to deliver optimal claim outcomes from ODG.
Contact us to schedule a consultation to ensure you're getting the most from ODG.
#20 RTW Prescription
Take control, setting and sharing best practice expectations for RTW at intake.
#19 UR Advisor
Approve quality care quickly and reduce waste, engaging UR only where justified.
#18 Comorbidity Calculator
Target and tailor best practice return-to-work and benchmarking data to the individual.
#17 The Procedure Summaries
Evidence-based care and UR guidance with clear recommendation and selection criteria.
#16 Medline Plus Connect
Reliable, relevant, up-to-date patient health education / pictures in English and Spanish.
#15 Opioid Dosing Alerts
Track morphine equivalents, receive alerts at evidence-based thresholds.
#14 Reserve Calculator
Take the guesswork out of reserves with predictive analytics at the claims desk.
#13 Savings Calculator
Quantifying the impact of claims efforts in days and dollars saved
#12 Drug Formulary
Clarity, purpose and peace of mind with pharmaceutical claims
#11 Risk Assessment
Resource optimizing through real-time risk assessment, triage
#10 Brand Matters
There is no "alternate" nor anything more accurate industry-wide
#9 Crossing Borders
Medical treatment is a human experience