CompPartners E-Brochure v2

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    08-Mar-2016
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Describes company mission and services.

Transcript of CompPartners E-Brochure v2

  • Partner. Its more than a part of our name.Its how we do business.

  • It all started with a simple idea... Partner with employers, the medical community and payers to get injured employees the best possible care in the shortest amount of time.

    Its the right thing to do. Doing these things gets injured employees back to work sooner. Turns out it also saves money for employers and payers.

    CompPartners portfolio of services is based on this simple yet powerful philosophy. We have proven it works time and time again since our company was founded in 1998.

    We have established a solid reputation for excellent service and quality results. Our services provide customers with peace of mind and lower overall costs.

    Its quality you can measure.

    Now CompPartners has expanded beyond workers compensation into group health and other insurance services all with the same goal: Excellent service to our customers and to their customers.

    With CompPartners, partner is more than just a part of our name.

    Its how we do business.

  • NETWORK MANAGEMENT SOLUTIONS The CompPartners approach to network management reduces costs, ensures the timely return to work of injured employees, and reduces litigation. How do we do it? We create strategic partnerships with clients like you who are committed to return to work and with the medical community. These two elements are critical to successful claim outcomes. We get everyone focused on returning to work, expedited delivery of medical services and quality care. Its all about partnership. We work with you to design a custom network and offer a conscientious approach to managing workers compensation injuries.

    We start by partnering with the medical community. Studies show medical professionals who specialize in occupational medicine have the greatest success treating work-related injuries. Physicians and specialists who are experienced in treating occupational injuries understand the importance of expediting appropriate care. They also understand the need for communication and setting attainable goals. We have contractual relationships with leading national networks. Having access to the best physicians and allied professionals in the country allows us to customize a network solution that fits your specific needs.

    The bottom line is that experience translates to lower costs, higher return-to-work rates, satisfied employees and less litigation.

    Next, we partner with our employers. Customers who are committed to early return to work reduce the overall costs of work-related injuries. We get everyone focused on the same common goals. How? By streamlining communication and offering rapid and succinct communication with all stakeholders.

    Finally, we partner with payors to design unique network solutions. Through a complete array of leading national networks, physicians and specialists experienced in occupational injury and illnesses are available to you and your injured employees. We work with you to design a customized network based on our exclusive network management model. Ours is the most effective network management approach available in the industry. Why? Because we focus on careful selection of network providers specifically for your business.

    Our exclusive network management model was developed expressly for workers compensation with a keen focus on expediting delivery of medical services to injured employees. Our model accelerates the communication process, helps gain prompt access to medical treatment for injured employees and allows efficient claims handling for claims administrators.

    Network solutions available: MedicalProviderNetworkMPN-California) HealthCareOrganization(HCO-California)certifiedsince1998 HealthCareNetwork(HCN-Texas) AnArrayofNationalNetworkContracts PharmacyPPONetworkwithaccesstoover50,000pharmaciesnationwide

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  • UTILIZATION REVIEW When it comes to Utilization Review, CompPartners has learned that our customers are most concerned about: timeliness, cost savings, communication and quality. Our UR service integrates the clinical experience of our highly qualified nursing staff plus URAC-certified Peer Review. Our UR serviceaddresses medical necessity and appropriateness of treatment by delivering timely review and recommendations for treatment.

    What can you expect from CompPartners utilization review?

    Timeliness. In many states, UR timeframes are mandated by state regulations. CompPartners has developed a system to ensure that every review is completed timely and follows state mandates.

    Cost Savings. The UR process helps achieve cost savings, while ensuring that injured employees receive appropriate medical care.

    Communication. Our process includes communication tools to relay timely communication to all parties i.e. adjusters, providers, treating facilities, and injured employees.

    Experienced Nursing Staff. Our highly qualified team of registered nurses receives ongoingtraining and continuing education on compliance and regulatory changes.

    Medical Director Oversight. MedicalDirectoroversightandtrainingofURservicesensuresthataccuratedecisionsaremadebased on evidence-based medicine and appropriate guideline application.

    The Utilization Review program addresses medical necessity and appropriateness of treatment for: ProspectiveReview ConcurrentReview RetrospectiveReview SecondOpinionReview

    Utilization Review services are used when you need to take a snapshot of a particular aspect of a claim to ensure everything is on track. For example, a review is done on a requested medical intervention, looking at appropriateness of treatment based on evidence-based medical guidelines.

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  • PHYSICIAN PEER REVIEWCompPartners offers unbiased, independent peer review services utilizing a standardized process and an aggressive quality assurance program.

    AsaURAC-accreditedIndependentReviewOrganization,CompPartnersenjoysbusinessrelationshipswith some of the most prestigious insurance carriers, self insured employers, and third party administrators in the country. Our peer review program maintains excellent quality standards in the areas of timeliness of reports, satisfaction, and appeals overturn rates.

    What can you expect from CompPartners Peer Review? Nationalnetworkincludinghundredsofmedicalspecialistsandalliedprofessionals representing essentially every medical specialty. Timely,accuraterecommendations Specialty-matchedreviewswithin48hours Determinationsandrecommendationsupportedbyevidencebasedmedicine DefensiblereportsthatmeetURACstandards Superiorcommunicationandcustomerservice Compliancewithstateregulations

    CompPartners physician peer review services includes the following: WorkersCompensation STD/LTD Medical/LegalOpinions GroupHealth AutoLiability

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    ACCREDITEDINDEPENDENT REVIEW ORGANIZATION

  • MEDICAL CASE MANAGEMENTCompPartners takes a different approach to case management. In the best interest of our customers, we provide medical case management services only in cases where we feel we can truly impact the outcome of the claim. Our nurses have the expertise to identify the most appropriate intervention, deliver the best outcome and provide faster return to work.

    What can you expect from CompPartners Case Management? Returntoworkisaddressedfromthebeginningoftheclaim Casemanagementonlyontheclaimswecandramaticallyimpactorperyourrequest Ournursesarepatientadvocates,ensuringappropriatecareandtimelytreatment Nursesuseevidence-basedguidelinestoidentifyappropriatetreatmentaswellas disability durations Nursesstreamlinethecommunicationprocess,communicatingtoallinterestedparties (claimsadministrator,treatingphysician,employer,injuredemployee) NurseshaveaccesstoourPeerReviewnetworkfordeterminingappropriatetreatments ReturntoWorkiscoordinatedforyourinjuredemployeesbyourskilledteamof professional case managers Experiencednursingstaffourhighlyqualifiedteamofregisterednursesreceives ongoing training and continuing education on compliance and regulatory changes Increasedemployeesatisfaction Reducedlitigation Oursystemwarehousesajobbankofallmodifieddutiesavailablewiththeemployer CaseManagerscoordinatethesuccessfulreturntofullormodifieddutybyactingas an intermediary between the treating physician, the appropriate employer representative, and the injured worker Bi-lingualcapability

    Case Management services are used when you need management of treatment, expedited delivery of medical services and premium quality care for injured employees.

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  • INTEGRATED MEDICAL MANAGEMENTCompPartners offers a comprehensive solution for all your workers comp needs. From prioritizing claims from the onset of injury to payment resolution to getting employees back to work, CompPartners iswithyoueverystepof theway.Acompletely integratedmedicalmanagementsystemhelpsyouunderstand your risks and allows you stay ahead of the curve when it comes to controlling your workers comp costs. This program is tailored to your specific business and maximizes your ability to control claims costs.

    Services include: FirstNoticeofInjury Claimprioritization/referralmanagement Customnetworksolutiondesignedespeciallyforyourbusiness Networkmanagementservices Comprehensivemedicalmanageme