Author Archives: Helen Knight

Restore Rehabilitation Launches National Telephonic Case Management

Owings Mills, Md. (March 29, 2016) — Restore Rehabilitation has launched a national telephonic case management service for workers’ compensation payers. Based in Maryland, Restore is a medical and vocational case management company focused on reducing the impact of workers’ compensation claims on injured workers, insurers, third-party administrators, and employers.

Restore’s telephonic case managers contact injured employees immediately after an injury to assess medical status and medical needs, determine next steps, assist in identifying physicians, and schedule appointments. “On the first call, we tell the injured employee that the employer wants us to help them navigate the work comp system,” said Restore Rehabilitation’s President Pam Anthony, RN, BSN, CDMS, CCM.  “Knowing your employer cares goes a long way.”

Restore’s telephonic case managers, who are registered nurses with advanced credentials, facilitate, educate and communicate so injured employees receive needed care as quickly as possible. This involves scheduling and following up on appointments, obtaining test results and medical records, and coordinating ancillary services. Case managers help injured employees understand their medical conditions, tests and treatment plans. Services include obtaining job descriptions, guiding return-to-work plans, monitoring psychosocial issues, and continually updating adjusters, employers and other stakeholders.

Restore Rehabilitation emphasizes superior customer service.  There is a dedicated multi-lingual team of case managers and a person answers the phone between 8:30 a.m. and 8 p.m. eastern to avoid voice mail delays.

“Our philosophy is to recruit, hire and train only the best of the best,” Anthony said, noting that Restore’s case managers are employees, not independent contractors.  “Our case managers are highly trained, credentialed and extremely experienced in workers’ compensation. Reasonable caseloads allow for proactive results-based services that surpass industry standards and exceed clients’ expectations.” 
 

About Restore Rehabilitation

Serving the workers’ compensation community, Restore Rehabilitation provides national telephonic case management, and field case management in 21 states.  It also offers an early intervention program, bilingual services, catastrophic case management, life care planning, file reviews, and medical cost allocations. Based in Owings Mills, Maryland, Restore Rehabilitation can be reached at 866-581-8771 or www.restorerehab.biz.  Pamela Anthony founded Restore Rehabilitation in 2006 and has grown it from two nurse case managers to 125 case managers.

 

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Media Contact:  Helen Patterson, APR, King Knight Communications, 813-690-4787; helen@kingknight.com

MedRisk’s Ruth Estrich Speaks at RIMS

King of Prussia, Pa. (March 29, 2016) — MedRisk’s Chief Strategy Officer Ruth Estrich and Macy’s Vice President of Risk Management Ann Schnure will share the stage at the 2016 RIMS Annual Conference and Exhibition on April 12. 

Their presentation, “Overcoming Psychosocial Barriers to Recovery:  Is it a Viable Solution?” explores integrated, patient-centric solutions to both physical and psychosocial barriers to recovery in workers’ compensation cases. Estrich and Schnure highlight psychosocial risk factors that affect work disability and share successes from a comprehensive, integrated program.  They also present strategies for evaluating and implementing delayed-recovery programs and key metrics for measuring return on investment. 

The session starts at 10:15 a.m. on Tuesday April 12.  RIMS will be held in San Diego, April 10-13.  For more information, please see https://www.rims.org/RIMS16/Pages/Home.aspx.

About MedRisk
MedRisk is the leader in physical rehabilitation and diagnostic imaging solutions for the workers’ compensation industry. Founded in 1994 and based in King of Prussia, Pa., MedRisk is accredited under URAC for utilization management and has successfully completed a SSAE 16 Type II examination. MedRisk’s programs deliver savings and operational efficiencies that are significantly greater than traditional programs. Customers include insurance carriers, self-insured employers, third-party administrators, state funds, and case management companies. To make a referral or obtain more information, visit www.medrisknet.com or call 800-225-9675. To learn more, follow MedRisk on Facebook and LinkedIn, https://www.facebook.com/MedRisk and  https://www.linkedin.com/company/medrisk-inc-/.

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Media Contacts: 
Helen Patterson, APR King Knight Communications helen@kingknight.com, 813-690-4787

Rommy Blum, MedRisk, Inc., 800-225-9675 ext. 1150; rblum@medrisknet.com

PRIUM Execs Speak at the National Rx Drug Abuse & Heroin Summit

Atlanta (March 22, 2016) – PRIUM executives take the stage several times during the National Rx Drug Abuse and Heroin Summit, March 28-31 in Atlanta.  PRIUM is a medical intervention company specializing in pain management for injured workers.

PRIUM’s President Michael Gavin, American Airline’s Director of Workers’ Compensation Jennifer Saddy, and the Treatment Research Institute’s Dr. David Gastfriend present “Advances in Treating Chronic Pain and Addiction” on March 29 at 3:30 p.m. The session focuses on psychosocial influences on chronic pain, non-pharmaceutical treatments, and managing workers’ compensation claims involving psychosocial pain.

“We need to address the intersection of chronic pain, mental health and addiction,” Gavin said. ”This is a complicated and expensive group of patients with unique needs.”

On March 30 at 11:15 a.m., PRIUM’s Senior Vice President Mark Pew and CompPharma’s Joe Paduda discuss how workers’ compensation drug formularies reduce opioid prescriptions and the clinical, logistical and regulatory components of a successful formulary.

“State formularies can positively influence prescribing behavior to help injured employees receive the most appropriate medications in a timely manner,” Pew said.

Pew returns for “The Five Things You Need to Know About: Marijuana & the Workplace; Litigation; Big Marijuana.” He discusses the implications of marijuana to the workplace, the impacts to employees and employers, and provides takeaways for advocacy. This session occurs on March 31 at 1:45 p.m. during The 3nd Annual SAM (Smart Approaches to Marijuana) Education Summit held in conjunction with the National Rx Drug Abuse and Heroin Summit.

The venue for both events is The Westin Peachtree Plaza, Atlanta.  For more information, please see http://nationalrxdrugabusesummit.org/.

About PRIUM

An Ameritox solutions provider, PRIUM sets the industry standard for workers' compensation medical interventions through a collaborative physician engagement process encompassing evidence-based medicine, clinical oversight, and jurisdictional guidelines to ensure optimal financial and clinical outcomes. PRIUM’s ability to secure higher agreement rates with physicians to modify treatment plans and ensure compliance is unmatched. The hallmark of the medical intervention company's success is to eliminate unnecessary treatment through a comprehensive approach that includes complex medical interventions, utilization reviews, and independent medical exams.  Based in Duluth, Ga., PRIUM can be reached at www.prium.com or 888-588-4964.

 

Website: www.prium.com

Blog: www.priumevidencebased.com

linkedin.com/in/markpew

Twitter: @PRIUM1 and @RxProfessor

 

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Contact:  Helen Patterson, 813-690-4787, helen@kingknight.com

Giving criticism

So this is why I never wanted employees:  I hate giving criticism and probably didn't do it well when I was managing people at other agencies.  Caroline Webb's article (published in Fast Company) is a great read for managers (and parents and people in general). I've been on the receiving end of the "praise sandwich" and it's tough going down.  Really like the part about being specific in your praise.  We absorb so much negative and some of us are programmed to hear the negative and tune out the positive. You really can't give enough specific praise.  

Tower MSA Partners’ New MSP Automation Suite Proactively Drives MSP Compliance and MSA Preparation

Delray Beach, Florida (January 25, 2016) — Tower MSA Partners has rolled out its comprehensive MSP Automation Suite. The sophisticated technology drives all the processes Tower has perfected to proactively manage Section 111 Mandatory Insurer Reporting, the recently implemented Conditional Payment Notice process, and to stage workers’ compensation claims for Medicare Set-Asides and closure. 

“Essentially, it automates our best practices for Medicare Secondary Payer compliance, claims optimization and MSA preparation,” said Tower CEO Rita Wilson.

Tower distinguishes itself by reducing medical and pharmaceutical costs before preparing MSAs.  “Our Pre-MSA Triage identifies barriers to settlement and recommends claim-specific interventions, like physician peer review and clinical oversight, to remove those barriers long before preparing an MSA,” she added.

The MSP Automation Suite can track a claim from Medicare beneficiary identification through final settlement. It records every claim activity performed by Tower or its network of practicing physicians and pharmacists and provides clients with 24/7, end-to-end visibility into claims. The system prompts for missing data, conditional payment searches, and medical/pharmaceutical interventions and sends electronic updates to clients at appropriate data points.

“Clients don’t need to manually diary activities or call to check on things,” Wilson said. “The system shows exactly when a phone call was made and follow-up is due.”

The MSP Automation Suite seamlessly integrates data from all types of claims systems and client business rules can be imbedded into the software alongside Tower’s rules for true business process management. “Automation frees claims professionals to address issues that require a human touch,” Wilson said.

About Tower MSA Partners

Headquartered in Delray Beach, Fla., Tower MSA Partners’ services include pre-MSA Triage, MSAs, physician peer reviews, conditional payments, Section 111 reporting, CMS submissions, MSA administration, medical cost projections, and life care plans. With more than 50 years combined experience in pharmacy, legal oversight and medical care, Tower proactively stages claims, working collaboratively with clients to identify issues and intervene to modify outcomes and remains involved in claims through final resolution. This model enables Tower’s clients to provide better care to injured workers, reduce claim and MSA costs, and obtain CMS acceptance of the MSA. For more information, visit www.towermsa.com and www.mspcomplianceblog.com.

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Media Contact:  Helen Patterson, King Knight Communications, 813-690-4787; helen@kingknight.com

Joseph McCullough Joins MedRisk

King of Prussia, Pa. (November 10, 2015) — MedRisk, a leading managed care company specializing in physical rehabilitation and diagnostic imaging in workers’ compensation, has named Joseph McCullough Executive Vice President of Customer Solutions.

He will be responsible for the development of new customer-focused solutions that improve the quality of healthcare, reduce medical costs and deliver operational efficiencies.

“MedRisk’s commitment to delivering effective solutions in a constantly changing landscape requires talent, leadership and an in-depth understanding of the workers’ comp community,” said MedRisk CEO Shelley Boyce.  “Joe’s experience in building successful workers’ comp specialty programs makes him a strong addition to our management team.”

McCullough has more than 10 years’ experience leading healthcare companies, most recently as president of OneCall Transportation + Language.  He also served as senior vice president of Optimal Care, the MSC division of Transportation and Language. In addition, McCullough is the former CEO of ZoneCareUSA and Select MRI prior to their acquisitions.

“I’ve admired MedRisk’s industry innovations for years and am excited about being part of this dynamic, customer-centric company,” said McCullough.

About MedRisk
MedRisk is the leader in physical rehabilitation and diagnostic imaging solutions for the workers’ compensation industry. Founded in 1994 and based in King of Prussia, Pa., MedRisk is accredited under URAC for utilization management and has successfully completed a SSAE 16 Type II examination. MedRisk’s programs deliver savings and operational efficiencies that are significantly greater than traditional programs. Customers include insurance carriers, self-insured employers, third-party administrators, state funds, and case management companies. To make a referral or obtain more information, visit www.medrisknet.com or call 800-225-9675.

 

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Media Contacts: 
Helen Patterson, APR, King Knight Communications, 813-690-4787; helen@kingknight.com
Rommy Blum, MedRisk, Inc., 800-225-9675 ext. 1150; rblum@medrisknet.com