Injury Management Strategies Bobbee Criner Objectives Injury Management
Injury Management Strategies Bobbee Criner
Objectives • • • Injury Management Strategies Team Structure Timeline and Deliverables Areas of Integration Customer Care Plan Staffing Model MCO Testimonials Case Management Levels and Strategies Dr. Christian Feedback Future Plans and MCO Involvement
New Business Model Terms • • • NBM IM PITCHQ SME Gen CCP EAP Triage CDU CCT CCG
IM Strategies Team Organization Staffing & CCP TIP IM PITCHQ Case Mgt. Strategies & Levels CDU
NBM Timeline
Prior to Gen One • Begin MCO Integration October 2004 • MCO Notes • Claim Reactivation • Staffing • CCP
Gen One July 2005 Basic CCP Case Management Levels Case Management strategies
Gen Two October 2005 Integrated CCP with EAP EM/IM Staffing IM management reporting
Gen Three January 2006 CDU Triage Level 2 Determinations CDU and Service Office Staffing CCP available externally MCO Final Integration
Integration Among NBM Teams AA/Triage Team MCO IM Team Foundations Team Employer Mgt. Team
MCO Integration Points Case Mgt. Levels & Strategies MCO CCP Staffing
Customer Care Plan • What’s been done • MCO Integration Details to be Developed
Staffing Model • What’s been done • MCO Integration Details to be Developed
MCO Testimonials • Lori Finnerty, Care. Works • Nancy Leeper, Summit. Comp
Case Management Levels and Strategies • What are Case Management Levels? • How are they different from Triage levels? • What are case management protocols?
Case Management Levels and Strategies • Four case management levels • Level 9 for conversion • Levels assessed in staffing • Protocols associated with Levels • Case Management Strategies
MCO Integration Details to be Developed • Staffing Model • Customer Care Plan • Case Management Levels and Strategies
Future Plans • Form an MCO/BWC Workgroup • Drive out MCO Integration Details
Questions?
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