Business View Magazine September 2018
102 At Chesapeake Employers, taking care of injured workers and managing claims is our business. Our experienced medical staff and claim specialists strive for better claims outcomes for injured workers. At the same time, we are committed to containing claims costs and keeping premiums as low as possible for Maryland employers. Our in-house integrated health team and claims management strategy is what we believe sets us apart from other workers’ compensation insurance companies. L-R: Kathy Piunti Claims Director Dr. Stephen Fisher Director Health Services Danielle Quinn , PharmD Pharmacist Robin Iachini , RN Health Services Manager Dr. Nechelle Nesmith Medical Utilization Specialist Dr. William Smulyan Medical Consultant Count on Chesapeake Employers for Your Workers’ Compensation Insurance Coverage n Professional Safety Services n Integrated Health & Claim Services n Competitive Prices n Corporate Dividends Program for Qualifying Policyholders Connect with your local agent for a coverage quote today or visit CEIWC.com Making a Difference: Integrated Health & Claims Services Y O U R W O R K E R S ’ C O M P E N S AT I O N S P E C I A L I S T Chesapeake Employers’ Health Services Advantage Our team of in-house doctors, nurses, pharmacist and physical therapist continues to work side-by-side with experienced claims professionals to ensure medical treatment for injured workers is swift, thorough, and appropriate. Our ultimate goal is to return injured workers to the job as soon as medically possible. 3 Doctors Two orthopedic surgeons, experienced in occupational injuries, provide medical advice on treatment interventions and cost containment opportunities. A third physician monitors high-cost pharmacy claims, provides guidance on compound and specialty drug protocols, and recommends alternative generic and lower cost prescriptions that deliver equivalent results. 25 Nurses Our nurses provide case management and medical services utilization review to ensure the medical treatment that the injured worker may need is appropriate and administered timely. 1 Pharmacist Our onsite pharmacist works with our Pharmacy Benefits Manager to monitor drug utilization and prescriptions related to the work injury while addressing any safety concerns associated with medications. The pharmacist also reviews opioid drug prescriptions. 1 Physical Therapist Our physical therapist monitors injured workers’ progress for short- and long-term goals and vigilantly reviews invoices for reasonableness. Highlights of this advantage teamwork include: Early claims intervention for potentially high-cost injuries – Injuries to the back can often become costly, with prolonged treatment, medications, and lengthy recovery times. These claims receive our early case management attention. Pre-certification of medical and surgical procedures – Our team reviews proposed medical treatments to confirm they are reasonable and medically necessary to ensure maximum recovery. Independent Medical Evaluation (IME) –We manage a network of physicians who have been evaluated to ensure they meet the highest standards to provide independent medical evaluations when a second opinion is needed. Medical bill review and prompt payment – Our billing specialists review medical bills for accuracy and prompt payment. They help manage costs by negotiating lower hospital fees and working with Preferred Provider Organizations (PPOs). Return-to-work program – Our nurses, claims adjusters, and safety consultants help employers create often customized return-to-work programs to help injured workers transition back to productive work as soon as they are medically able. Y O U R W O R K E R S ’ C O M P E N S AT I O N S P E C I A L I S T PROUD TO HAVE EARNED AN A-(EXCELLENT ) FINANCIAL STRENGTH RATING FROM A.M. BEST
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