So now that you know you have some complex cases, what to do? Kevin Glennon, RN, BSN, CDMS, QRP and Vice President of Clinical Services of Total Medical Solutions, suggests knowledge is essential. Get to know your claimant and have a first hand understanding of all aspects of the claim. Know the relevant medical issues, potential complications, range of treatment options and home health / equipment options available. Seek the help of an experienced home health partner with expertise in managing complex workers' comp injuries.
When seeking the help of a home health partner, look for comprehensive and pro-active treatment plans that include:
- Identification of all current medical issues and staff involved
- List of all treatments, pharmaceuticals, equipment and supplies
- Potential complications and recommended safeguards
- Appropriate equipment recommendations
- A list of co-morbidities
- Recovery timeline with goals and objectives
- A return-to-work plan, if applicable
Glennon says the cost of complex claims can be dramatically impacted by pro-active planning and by using an experienced supplier. While the carrier may spend more money up front to prevent expensive complications at the end, the overall cost of the claim can be greatly reduced.
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