Other Services
Return to Work
Gregory B. Bragg & Associates will work closely with you in establishing your Return to Work program, if needed. We will also assist in facilitating the exchange of medical information to enable a timely placement as soon as the physician allows. With the cost of workers’ compensation skyrocketing and the increased temporary disability rates mandated by legislation, this is an excellent opportunity for employers to control costs.
Medical Cost Containment
Medical cost containment is a fundamental component to a successfully administered workers’ compensation program. Gregory B. Bragg & Associates offers a comprehensive medical cost containment program using a combination of bill review, utilization review, a medical provider network and access to a number of preferred provider organizations.
Bill Review
Our sophisticated bill review software and claims management system allows us to easily interface and coordinate with the claims staff as well as outside managed care providers. A utilization review and nurse-case management interface enables treatment plan modifications or denials to be entered or automatically transmitted into the bill review software.
Lien Resolution
Excessive and complicated liens are handled by our lien specialists, who are also available for Board appearances.
Medical Provider Networks (MPNs): MPNs, which may now be established by employers, enable them to maintain medical control over the life of a workers’ compensation claim. MPNs offer employers a unique opportunity to contain medical costs while improving the treatment process for injured workers. The goal of an MPN is high-quality, prompt medical treatment for injuries under strict timelines, with some physician choice, and a safe and early return to work. We will assist in developing a panel of medical providers. Many MPNs can be setup for no fee, yet there may be small fees associated with detailed customization of a panel.
Utilization Review
Utilization review for hospitalization, specialist referral, and other high-cost procedures is an effective tool against over utilization or inappropriate care.
Nurse Case Management
Gregory B. Bragg & Associates has partnered with onsite nurses to provide insight and direction on medical issues. Indemnity cases are initially reviewed for necessity and “Red Flag” cases receive early involvement. These cases usually consist of serious injury, prolonged disability, or treatment with poor reporting physicians. Nurses enter their notes and plans of action into our computer system for client review. The nurses can perform telephonic or field case management with injured workers and their physicians. They can also provide consultation services to better assist the claims staff.
Chiropractic Case Management
Chiropractic Case Management Services apply a peer-to-peer approach in which a licensed chiropractor will call or even visit the treating Chiropractor. This is a proactive approach to managing complex chiropractic cases and provides the claims administrator with the ability to obtain accurate, up to date progress reports, disability status, work restrictions and a return to work plans.
Early Intervention/Triage
Early intervention provides the best opportunity to make an impact at the most critical stage of medical care, the beginning. This service incorporates aggressive early medical intervention into the initial claims process. Licensed nurses assess medical treatment by reviewing the First Report of injury and contacting the treating provider. The nurse will ensure appropriate medical care and identify any barriers impacting return to work and recovery. The initial contact will confirm network (MPN) utilization and timely referrals to case management and ancillary services if necessary. The initial medical assessment with recommendations will be documented into the claims system including: Treatment plan, work restrictions, RTW date and anticipated length of disability. This frequently eliminates the need for Utilization Review and expedites treatment.
Field Case Management
Our Field Case Management provides an in-person evaluation of the injured worker, provider and/or job site while coordinating care and services to promote recovery and return to work.
Telephonic Case Management
Our case management service focuses on the continued assessment and coordination of medical treatment for the injured worker. Our philosophy of "managing not monitoring" facilitates treatment, timely RTW and claim resolution by maintaining open lines of communication with the injured worker, employer, physician and claims team.
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