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Question: How Does CompAlliance Define Successful Medical Case Management?

Answer: Our main objective is complete customer satisfaction. We can tailor any of our products to meet your specific needs. While all case management vendors provide you with information, our goal as a strategic business partner is to ensure you are provided not only with the facts but with an analysis that allows the claims professional to make informed decisions that lead to successful case closure. CompAlliance staff receive ongoing in-house training and education and have a clear understanding of the scope of their role as determined by state licensure and CCM and CCRC standards. CompAlliance staff recognize the adjudication role of the adjuster. By working as a team, we proactively ensure appointment coverage regardless of the consultant’s schedule, to obtain timely information regarding diagnostics, treatment plans, projections and ensuring the physician focuses on functional capabilities both at home and at work at each appointment, with the goal of a successful RTW and MMI whenever possible. CompAlliance case managers are trained to be proactive, not reactive. CompAlliance utilizes Predictive Modeling as part of evaluating any diagnosis and treatment plan, providing more accurate timelines and figures for the adjuster when calculating reserves. A first level of UR is built into our CM process as a result of utilizing ODG guidelines and providing analysis of the Evidence Based Guidelines. All communications to the IW transferred to Plain Language to ensure understanding. CompAlliance utilizes bilingual staff whenever possible or available. Languages spoken by our Case Management Staff are Spanish and Polish. All communications prepared for the IW are translated to these languages and are also transferred to Plain Language. CompAlliance staff are located throughout our territory; this minimizes travel time and costs are lower! All CompAlliance medical case managers are licensed in the states in which they practice, and our vocational consultants are masters prepared. These educational levels ensure the knowledge base and expertise you expect! CompAlliance advocates use of and provides accurate and detailed video JA by a Vocational Consultant as a key to early RTW. All CompAlliance Nursing Supervisors are nationally certified in URAC approved certifications, which assists in facilitation of quality oversight of your cases. CompAlliance Case Managers are respected by attorneys and physicians in the claims arena; resulting in good working relationships and timely communication with all parties. CompAlliance consultants communicate with the account via email within strict timeline standards unless otherwise requested.

Answered by: CompAlliance

Categories:  Workers Compensation  Injured Workers  Nurse Hotline    

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 CompAlliance Workers Compansation Case Management