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We are committed to providing the We are committed to providing the highest quality and cost-effective highest quality and cost-effective
medical management services medical management services available to promote a safe and available to promote a safe and healthful environment for your healthful environment for your
employeesemployees- Dr. Michael J. DeLitta- Dr. Michael J. DeLitta
Who Are WeWho Are We Injury Management ProcessInjury Management Process Two Case ExamplesTwo Case Examples Stats on Immediate InterventionStats on Immediate Intervention ClosingClosing
Injury Case Injury Case Management Management TopicsTopics
We are 24/7 - We don’t close at 5We are 24/7 - We don’t close at 5
How TPA Different From How TPA Different From AxiomAxiom
We understand OSHA and its We understand OSHA and its importance to our clientsimportance to our clients
All Case Managers (CM) are medically All Case Managers (CM) are medically licensed (minimum of RNs)licensed (minimum of RNs)
Our CMs carry a case load of less than Our CMs carry a case load of less than 15 – 20 cases (compared to 100 – 200)15 – 20 cases (compared to 100 – 200)
– Occupational and Environmental Medicine Occupational and Environmental Medicine – Internal Medicine Internal Medicine – Family Practice Family Practice – Medical Review Officers (MRO) Medical Review Officers (MRO) – Qualified Medical Examiners (QME) Qualified Medical Examiners (QME) – Masters in Public Health (MPH) Masters in Public Health (MPH)
If the injury is critical or life threatening If the injury is critical or life threatening call 911 and then contact Axiomcall 911 and then contact Axiom
Never delay treatment in the event of Never delay treatment in the event of an emergencyan emergency
If the injury is not an emergency If the injury is not an emergency contact Axiom contact Axiom beforebefore you transport you transport the employee to a medical facility – the employee to a medical facility – this is important and will be explained this is important and will be explained
If a medical facility is indicated, CM If a medical facility is indicated, CM directs employee to directs employee to appropriateappropriate medical facility and provides initial medical facility and provides initial info on case to health care providerinfo on case to health care provider
If a medical facility is not indicated, CM If a medical facility is not indicated, CM will provide 1will provide 1stst aid recommendations aid recommendations and monitor employee’s conditionand monitor employee’s condition
50% of cases never require clinic visit50% of cases never require clinic visit CMs do NOT diagnose, nor do they need CMs do NOT diagnose, nor do they need
to in order to provide 1to in order to provide 1stst aid measures aid measures
Employee and person calling in case (i.e., Employee and person calling in case (i.e., HSE, supervisor) must be in agreement HSE, supervisor) must be in agreement with CM’s 1with CM’s 1stst aid recommendations) aid recommendations)
CM provides a direct number to employee and CM provides a direct number to employee and supervisor to call with any questions, problems supervisor to call with any questions, problems or changesor changes
Keep mgmt and HSE updated via Keep mgmt and HSE updated via phone and e-mail during entire processphone and e-mail during entire process
Follow employee until able to perform Follow employee until able to perform regular duties or until adjuster regular duties or until adjuster assigned – depends on client’s assigned – depends on client’s preferencepreference
Medical Case Medical Case Management Management Case #1Case #1
TuesdayTuesday 5:45 PM - Spoke with ER doc5:45 PM - Spoke with ER doc
• X-rays negativeX-rays negative• Diagnosis - hematomaDiagnosis - hematoma• Plan to give prescription if infection Plan to give prescription if infection
occursoccurs• Told doc we would follow case & look for Told doc we would follow case & look for
infection. Prescription not writteninfection. Prescription not written• Return to work (RTW) - full dutyReturn to work (RTW) - full duty
Medical Case Medical Case Management Management Case #1Case #1
WednesdayWednesday 8:45 AM - Spoke with Supervisor 8:45 AM - Spoke with Supervisor
(Supv) and EE. EE doing well. (Supv) and EE. EE doing well. Regular duties. Reviewed Regular duties. Reviewed importance of OTC NSAIDs and iceimportance of OTC NSAIDs and ice
FridayFriday Spoke with EE and Supv. EE still doing Spoke with EE and Supv. EE still doing
well. No sign of infection. Case closedwell. No sign of infection. Case closed
Medical Case Medical Case Management Management Case #2Case #2
FridayFriday Had Spanish-speaking Case Manager Had Spanish-speaking Case Manager
speak with EEspeak with EE Determined injury was soft tissue onlyDetermined injury was soft tissue only After getting thorough medical history After getting thorough medical history
EE was instructed on ice, heat, NSAIDsEE was instructed on ice, heat, NSAIDs Gave direct number to EEGave direct number to EE
Medical Case Medical Case Management Management Case #2Case #2
SaturdaySaturday EE off work, but called him at homeEE off work, but called him at home Reviewed treatment plan and Reviewed treatment plan and
discussed starting heat on Sundaydiscussed starting heat on Sunday Spoke with EE on Monday at workSpoke with EE on Monday at work Significant improvement. Told to Significant improvement. Told to
continue treatment plancontinue treatment plan Closed case on TuesdayClosed case on Tuesday
75% of cases - notified same day75% of cases - notified same day 14% of cases - the following day14% of cases - the following day 11% of cases - notified 2 days or greater11% of cases - notified 2 days or greater
• 40% of these were over 1 week40% of these were over 1 week
• 80% of those were placed on OSHA 30080% of those were placed on OSHA 300– All 6 lost times fell into this category All 6 lost times fell into this category
If case received within 24 hrs of injury If case received within 24 hrs of injury the average time to close was 7 daysthe average time to close was 7 days
If case received within 2 days of injury If case received within 2 days of injury the average time to close was 14 daysthe average time to close was 14 days
If case received on 3rd day or greater If case received on 3rd day or greater following the injury the average time following the injury the average time to close was 32 daysto close was 32 days
Immediate access to Medical Immediate access to Medical Professional 24/7 for injuriesProfessional 24/7 for injuries
Employee can call CM at any time Employee can call CM at any time should medical condition change should medical condition change or if question comes upor if question comes up
Axiom Case Manager is not a Axiom Case Manager is not a “Company Doctor”“Company Doctor”
Immediate access to Medical Immediate access to Medical Professional 24/7 for injuriesProfessional 24/7 for injuries
Supervisor removed from treatment / Supervisor removed from treatment / medical decisionsmedical decisions
CommunicationCommunication Lower Claims Frequency/SeverityLower Claims Frequency/Severity Reduction in Incident Rate, Reduction in Reduction in Incident Rate, Reduction in
Costs, Reduction in ModifierCosts, Reduction in Modifier
It’s important to report injuries It’s important to report injuries immediately – no matter how minorimmediately – no matter how minor
A delay of reporting and treating A delay of reporting and treating injury by 1 day increases injury by 1 day increases recordability by 60%recordability by 60%
24 / 7 /365 coverage - (this is crucial)24 / 7 /365 coverage - (this is crucial) Have only one number to callHave only one number to call