Workers'
Compensation Services . . .
Case Management & Medical Cost Containment
Case Management:
The process starts at TriSurant with a team analysis of each claim
and early referral to one of TriSurant's nurse case managers.
Our experience has been that costs are decreased and the employee
returns to work earlier when a nurse case manager gets involved
quickly.
It is a registered nurse who provides aggressive telephonic and
field case management to help actively direct medical treatment.
The nurse conveys vital information to the adjuster and the client
immediately following a doctor's appointment. This speed of communication
eliminates that lag time so often associated with doctors' dictations
and the written report arriving on the adjuster's desk. The proactive
coordination of information can eliminate up to four weeks of
TIBS payments.
The nurse case manager is cross-trained and works closely with
the TriSurant Medical Director to facilitate pre-authorization.
Nurse case managers enter updates to system files and provide
authorized members of the TriSurant team and the client with current
status information.
TriSurant has raised the bar with our
integrated approach to nurse case management.
Medical Cost Containment:
Our integrated services are structured for extraordinary results.
These services include medical bill audit and payment, pre-authorization
services by Registered Nurses certified in case management, utilization
review and telephonic as well as field Registered Nurse case management.
The integration of pre-authorization, case management and medical
bill audit provides comprehensive and accurate reserve settings.
We recognize the cost of healthcare as the driving force of the
workers' compensation system. All aspects of claims are coordinated
by a director with a background in medicine and many years experience
in the workers' compensation system. This provides a level of
sophistication unique to TriSurant.
The TriSurant Workers' Compensation Services department is certified
by the Texas State Department of Insurance.
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