Getting Difficult, Frustrating and Expensive Claims Unstuck
Jennifer Christian, President, Webility Corporation
Steven D. Feinberg, Pain-Management Physician, Feinberg Medical Group
Lee Glass, Associate Medical Director, Washington State Department of Labor and Industries
11 a.m. - 12: 15 p.m.
Moving difficult and expensive claims toward a positive resolution may require modifying
traditional medical approaches that all too frequently turn simple injuries into catastrophic cases.
Three medical experts will share strategies that start with identifying obstacles delaying healing
and recovery, and then offer biopsychosocial interventions for overcoming those obstacles
and getting stuck claims moving in the right direction. You’ll learn solutions, including improved
communications with workers and physicians, gleaned from successes resolving real-world
claims, and hear examples and results from workers’ comp entities applying the strategies.
• Recognize why traditional medical and claims management often fail
• Implement strategies that can get claims unstuck
• Integrate early intervention and biopsychosocial strategies
Medical Roundtables for Resolving Tough Issues Hindering
Suzy Braden, Workers’ Compensation Claims Manager, Encompass Health
JJ Schmidt, SVP – Managed Care, Care Works Managed Care Services
2: 30 - 3: 45 p.m.
Traditional claim reviews give limited attention to medical-cost drivers, even though clinical services
generate most claim expenses. That wastes opportunities to improve injured-worker outcomes
in medically challenging cases. Claim medical roundtables, in contrast, gather physicians,
pharmacists, medical case managers and claim-team members to identify and address clinical
issues delaying recovery. They provide information needed to identify and address specific
medical challenges holding up a claim. Hear how Encompass Health leveraged the approach to
develop strategies that speed claim resolutions.
• Distinguish medical roundtables from traditional claim reviews
• Plan a medical roundtable approach to claim reviews
• Recommend medical roundtables that advance complex claim resolutions
Thursday, Dec. 6
Delivering and Measuring Value-Based Care Within
Silvia Sacalis, VP of Clinical Services, Healthesystems
Adam Seidner, Chief Medical Officer, The Hartford
10: 45 - 11: 45 a.m. [Repeated at 4: 15 - 5: 15 p.m.]
The potential to replace inefficient fee-for-service healthcare delivery with value-based care
models emphasizing greater injured-worker engagement is generating considerable discussion
across workers’ comp. But how is “value” defined, effectively delivered and measured within
workers’ comp managed care? Adam Seidner and Silvia Sacalis will answer those questions and
provide examples of programs driving value and greater stakeholder involvement. You’ll leave with
practical strategies for greater patient engagement and employee health promotion, as well as
practices that improve outcomes and increase cost savings.
• Examine key concepts defining a workers’ comp value-based model
• Outline patient-engagement initiatives and tools, such as outreach
• Describe programs empowering employers to create healthy
Biggest Savings — Register by Oct. 3 to SAVE $350.00! 12