Workers Compensation Medical - Broward County...rx3 Q-c cu > o Proven Process Talented Experienced...
Transcript of Workers Compensation Medical - Broward County...rx3 Q-c cu > o Proven Process Talented Experienced...
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Workers Compensation MedicalCost Containment and Case
Management Services
October 18, 2018
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Slide 2
PRESENTATION AGENDA
INTRODUCTION
MEDICAL MANAGEMENT
PROVIDER NETWORKS
COST CONTAINMENT
CONCLUSION
AmeriSys''
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Slide 3
LEADERSHIP TEAM
AmeriSys*
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Slide 7
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Slide 9
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EARLY INTERVENTION /TRIAGE
^ 24/7/365 Service
On Call Nurse for Emergencies
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Slide 10
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Slide 11
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Slide 12
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"The nurse's talent and skills drive
benefits, Includingfaster return to workat a lower cost
Nurses are able to use the connections to
facilitate Innovation and guide decisionsthat lead to better outcomes for Injured
workers and businesses."
Confmnce Chronicles
2015 Nellonal Workers'Conipent*tlon& DtssbilttyConference, MecyO'OonDthue, VicePresident. Medical
Services, Helmsmen Menegement Services and StephaniePetllN,Senior Director. Medical & Health Manetemenc.
The Home Depot
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Slide 13
J ACCREDITATION
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CERTIFICATE OF AWARD
HSIS, Inc. dba AmeriSys5728 Major Blvd, Suite 450
Orlando, Florida 32819
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Slide 15
PHARMACY PROGRAM
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Slide 16
PROVIDER SERVICES
Reporting
Provider
Services
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Slide 17
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Slide 18
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LIFE OF A BILL
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Slide 20
COST CONTAINIVIENT
Turnaround ReportFiscal Year End: October 2016 - September 2017
Average Days from Average Days Average Days Average Days
Count Bf""Receipt toASI from ASl Receipt from Bill Review fromBrowardReceipt to Posted Receipt to Export Received to Paid
4,091
Medical BDI Fliiitg Parromunee
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Slide 21
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Slide 23
PPO/CONTRACTED SAVINGS
Fiscal Year End: October 2016 - September 2017
GRAND TOTAL Bilts Btll ChargesFeoSclu'dul,'
Olll^t P(>0
Physicians 3,965 8,109 $1,971,032.69 $996,909.36 $191,623.76 $13,460.95Hospital inpAlicr^t 15 228 5644,505.80 $335,311.69 $25,217.46 $7,376.89Hospitjl Oulpjtienf 182 1,130 $1,047,769,37 $415,781.19 $92,495.85 $41,522.26Ambuialotv St.tglcdl 62 178 $840,674.47 $412,638.11 $62,756.90 $14,163.02Physk^lTheraoy 2490 5,773 $543,987.01 $210,284.30 $5,636.60 $77,635.98Didgnostics 124 135 $174,471.66 $109,866.03 $3,177.17 $12,669.98Chiropractic 4 24 $1,457.12 $821.12 $0 $0DME 179 307 $104,531.84 $23,302.98 $4,189.40 $27,902.12Prescriptions 1,217 1,713 $438,687,37 $13,893.55 $14,953.30 $79,136.68Other 336 1,072 $134,576.06 $44,398.06 $17,085.49 $10,226.27TOTAL 8,474 18,669 $5,901,688.39 $2,563,226.39 $417,135.93 $284,094.15
Savings
Reduction %43.43K 7J)7K
4.81K
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PPO/Contracted Savings Billed Charges% of Overall Redjction reialed to PRO/
Contracted Saving
PPO/Contracted Savings Billed Charges Fee Schedule and Other Savings % of PPO Savings below Fee Schedule
9.72%
AmeriSys*
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Slide 24
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Slide 25
INFORMATION SYSTEMS
Corrus
/
Programs That Work For You
AmeriSys*
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Slide 26
INFORMATION SYSTEMS
> Setup of your systems
> Software for adjusters
> Software for First Report Notice of Injury
> Security protocol
AmeriSys*
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Slide 27
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J Slide 28
AmeriSys hascontracted and
added numerous
vendors on
behalf of Broward
V P CLAIMS
Since 2016, USIS
has been
handlingBroward County
VIP claims
AmeriSys*
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Slide 29
OPTIONAL SERVICES
USIS/AmeriSys will contract with the service providers ofBroward County's choice.
OCCUPATIONAL, MEDICAL, DRUG, AND ALCOHOL POLICIES
DRUG AND ALCOHOL SCREENS
OCCUPATIONAL MEDICAL CONSULTATION
SUBSTANCE ABUSE SERVICES
INVESTIGATIVE SERVICES AND SURVEILLANCE
SAFETY AND OCCUPATIONAL HEALTH SERVICES
ALL-LINES CLAIMS ADJUSTING
^ USIS currently provides VIP claims adjusting services
AmeriSys*
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USIS/AmerTSys take PridejrtPrdvidi% Custorrier^Getitrici
THANK YO