Your 10-Step Guide to Managing Catastrophic Claims

Written by on 10/4/2017 3:03 AM in , , , , . It has 1 Comments.

Catastrophic workman's comp claims are especially challenging to manage. Care of injured workers is often fragmented, with multiple providers and no holistic, long-term plan of care. Without centralized management, optimal care and quality of life cannot be achieved, leaving health to deteriorate and costs to creep to alarming levels. Fortunately, there are ways to proactively and successfully manage catastrophic claims.

How Can You Pave the Way to Effective Catastrophic Claims Management?

Understand the scope of the problem.
Catastrophic workman's comp claims account for only 1% of claims – but 20-30% of total medical spending in the workcomp arena. Medically complex and costly, such injuries require sophisticated care, equipment, and rehabilitation. Such life-altering injuries require a high-touch, compassionate response and include:

  • Brain/spinal injuries
  • Vision loss
  • Para/quadriplegia
  • Severe burns
  • Multiple traumas or amputations

Strive for collaborative care.
Safeguarding patient well-being while controlling costs is possible. Whether in-house or through a third-party provider. Develop a collaborative, team approach to provide ongoing coordination of services from primary care to equipment, drug utilization, home care and support.

Report early.
Notify your catastrophic claims team while the injured worker is still in the hospital to ensure a smoother progression from hospital to home care, especially in the event medical equipment such as a wheelchair is necessary.

Don’t overlook the big picture.
Comprehensive evaluation(s) of long-term needs are key to a successful transition. An in-depth evaluation of injuries, comorbidities, home and family situations, and injured worker feedback can head-off unexpected and costly complications.

Uncover other ways to pave the way to more effective catastrophic workman's comp claims management in part 2 of this Minnesota Comp Advisor series.


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