Overview
CorVel’s Enterprise Comp offers a new approach to healthcare, disability management and claims administration. CorVel has combined several emerging technologies to automate the management of disability claims. This automation allows claims management resources to be focused on those claims in most need of attention. This innovative, automated service model controls claims at inception by advocating medical management at the onset of the injury to decrease claims administration costs and shorten the length of disability. Our solution offers a personalized treatment program for each injured claimant, using precise treatment protocols to meet the changing needs of patients on a daily basis - advocating timely, quality care for employees. By integrating claims and disability management, our Enterprise Comp program offers an unprecedented opportunity for our customers to have more control over their Workers' Compensation program. Enterprise Comp a service model without equal in the industry, providing employers the opportunity to significantly reduce their Workers’ Compensation program costs.
The Advantage
Claims are reported via an on-line First Notice of Loss (FNOL) form on our website www.caremc.com. Each FNOL is then immediately processed by our proprietary rules engine which analyses all available claim data. Our technology instantly assigns all cases meeting criteria to an expert claims specialist, the CorVel Outcomes Manager, while simultaneously determining if a claim requires any immediate attention, such as case management or investigation. Those claims determined to require no further attention are filed and associated medical bills are processed via CorVel’s proprietary bill review & PPO management program. For those claims that require additional attention, the system alerts the appropriate person (outcomes manager, supervisor, case manager, risk manager, all of whom are "connected" in real time to us) to answer questions concerning the claim. Once the questions are answered, the claim is re-evaluated and any additional questions are surfaced and addressed. A determination is made as to whether the case is a med-only or lost time situation. Recommendations are then made regarding the appropriate course of action for each situation i.e. immediate referral for medical case management, PPO channeling, medical payment resolution or vocational services.
The Difference
The utilization of our innovative technology and leading medical expertise at the onset of a claim will significantly reduce our customer’s workers’ compensation costs, including administrative fees, medical costs and indemnity reserves. From initial claim prioritization to the employees return to work, CorVel’s Enterprise Comp is the most comprehensive solution for any employer's Workers’ Compensation needs. CorVel’s innovative services provides a fully integrated rules-based Claims Administration - Managed Care solution that will reduce both claim and administration costs. Central to CorVel's Enterprise Comp program is the automation of much of the claims management process allowing for a focusing of resources on the proper claims, elimination of the "diary system" and its attendant delays and lack of attention to deteriorating claims, and the elimination of the inevitable mistakes inherent in manual processes.
Bottom line
What sets Enterprise Comp apart from traditional workers' compensation claims and disability management programs is first and foremost, the ability to apply sophisticated "rules based" disability and claims management technology to each and every claim from day one through to case closure, insuring the timely deployment of the appropriate disability management service. Secondly, the ability to reduce claim administration costs through the use of CorVel's integrated claims management services. By establishing a day one medical management process, claims that would otherwise lap into lost time status are resolved before this occurs. Lost time claims are managed more aggressively from day one thus reducing indemnity costs as well as the financial cost of impact of lost productivity. Finally Enterprise Comp has the ability to function as a full service fully-integrated claims administration and disability management system or can integrate with the employers existing claims management processes if preferred.
Our results to date are an impressive 18% reduction in total incurred costs, and a 30% reduction in lost time claims.
In Summary
CorVel has taken traditional claims management, applied state of the art technology, along with our long-standing ability to customize services to create our Enterprise Comp Program…..a totally-integrated, medical and claims management solution. The CorVel approach to workers’ compensation services focuses on improved outcomes and overall reductions in claims costs by leveraging technology, and by utilizing aggressive interventions from the very moment a claim is reported.
CorVel’s Early Intervention procedures are designed to reduce the number of Lost Time claims and to minimize the costs associated with these cases when they occur. Now, by fully and seamlessly integrating the managed care and claims management processes and through the deployment of CorVel’s proprietary Rules-based technology and expertise, our clients are able to minimize the costs of the Worker’s Compensation program by reducing both claim and administrative costs to levels never before possible.
Enterprise Comp…..the “single source” solution to rising Workers’ Compensation costs.
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