[MCOH-EH] Worker's Compensation

[Darlene Sims]

Workers' Compensation is a part of  HR at our system and oversee a population of approximately 5,700 employees at multiple sites (hospitals/clinics).
All claims are managed by a Workers' Compensation Specialist, who is a non-clinician and works directly with PMA. (This role is under the purview of a HR Director) We use a TPA for all claims management, approvals, setting reserves, paying benefits, and invoices. The TPA we use is PMA.
Legal issues, court hearings etc., are through HR and the organizations workers' compensation attorney.

Our Employee Health and Safety department is the first line in workers' compensation claim treatment - where an employee is seen by a nurse and NP if needed.  A case manager is assigned to all claims that are on going.  The director of our Employee Health Department is a NP.  
If an injured employee requires a higher level of care, then a referral is made to an occupational health MD (emergency room is used for after hours injuries that require immediate treatment);  All return to work releases must be evaluated through our Employee Health Department This has been our structure for several years

A annual claims stewardship review is held with Executive Team, which includes, Risk and Finance, so that ongoing claims and reserves are adequate as well as monitoring the efficiencies of the TPA.

Darlene Sims, MSN, FNP-C
Director, Infirmary Employee Health Services
Responding for:
Judy Stitt
Director, Infirmary Health Human Resources
Benefits, Employment and
Regional Staffing Pool
Office:  251.435.2211
Direct:  251.435.5720


-----Original Message-----
From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of mcoh-eh-request at mylist.net
Sent: Monday, July 01, 2019 10:08 AM
To: mcoh-eh at mylist.net
Subject: [EXTERNAL] MCOH-EH Digest, Vol 254, Issue 201

Send MCOH-EH mailing list submissions to
	mcoh-eh at mylist.net

To subscribe or unsubscribe via the World Wide Web, visit
	https://mylist.net/listinfo/mcoh-eh
or, via email, send a message with subject or body 'help' to
	mcoh-eh-request at mylist.net

You can reach the person managing the list at
	mcoh-eh-owner at mylist.net

When replying, please edit your Subject line so it is more specific than "Re: Contents of MCOH-EH digest..."


Today's Topics:

   1. Re:  Worker's Compensation (Jerry Burleson)


----------------------------------------------------------------------

Message: 1
Date: Mon, 1 Jul 2019 15:08:11 +0000
From: Jerry Burleson <Jerry.Burleson at nhrmc.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Worker's Compensation
Message-ID:
	<BN8PR10MB353796FAB0C7BC10AE9E091792F90 at BN8PR10MB3537.namprd10.prod.outlook.com>
	
Content-Type: text/plain; charset="utf-8"

She was a field WC Case Manager prior to her employment here.


Jerry L. Burleson, RN, MBA
Manager, Employee Health and Clinic
New Hanover Regional Medical Center
PO Box 9000
Wilmington, NC 28403-9000
(910) 667-5663 ? Office
(910) 612-8770 ? Cell
(910) 667-5695 ? Fax
Jerry.burleson at nhmrc.org<mailto:Jerry.burleson at nhmrc.org>

Leading our Community to Outstanding Health

[cid:image002.jpg at 01D16A68.40331E50]

[Forbes Best Logo] [Forbes 2019 CL crop]   [cid:image004.jpg at 01D51AEA.77058EA0]   [cid:image003.jpg at 01D51616.C7FC7400]

Confidentiality Notice: If you are not the intended recipient of this message, you are not authorized to intercept, read, print, retain, copy, forward, or disseminate this communication, its enclosures or attachments. This communication may contain information that is proprietary, confidential, protected health information (PHI) which is subject to HIPAA privacy and security guidelines, or otherwise legally exempt from disclosure. If you have received this message in error, please notify the sender immediately either by phone (910.667.5307) or by return e-mail and destroy all copies of this message (electronic, paper, or otherwise).

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Charles Hackett
Sent: Monday, July 1, 2019 10:17 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Worker's Compensation

** CAUTION: External Email **
Do not click links or attachments unless you recognize the sender and know the content is safe.

Thank you
What is the background of the case manager Charlie Sent from my iPhone

On Jul 1, 2019, at 10:12 AM, Jerry Burleson <Jerry.Burleson at nhrmc.org<mailto:Jerry.Burleson at nhrmc.org>> wrote:
Our organization is approximately 7,500 employees with Employee Health responsible for the entire WC program and reporting to the CHRO.
We are self- insured using a TPA for claims management.
I currently have a dedicated WC Case Manager as the liaison/resource for the injured employee and the TPA.
Risk Management is not involved with the WC process We have ACPs that initially manage the injured patient and refers out to specialists as needed.

I have been recently pondering if the Case Manager is benefitting our organization or could the TPA include this service.

Thanks.


Jerry L. Burleson, RN, MBA
Manager, Employee Health and Clinic
New Hanover Regional Medical Center
PO Box 9000
Wilmington, NC 28403-9000
(910) 667-5663 ? Office
(910) 612-8770 ? Cell
(910) 667-5695 ? Fax
Jerry.burleson at nhmrc.org<mailto:Jerry.burleson at nhmrc.org>

Leading our Community to Outstanding Health

<image001.jpg>

[Forbes Best Logo][Forbes 2019 CL crop]  [cid:image004.jpg at 01D51AEA.77058EA0]   [cid:image003.jpg at 01D51616.C7FC7400]

Confidentiality Notice: If you are not the intended recipient of this message, you are not authorized to intercept, read, print, retain, copy, forward, or disseminate this communication, its enclosures or attachments. This communication may contain information that is proprietary, confidential, protected health information (PHI) which is subject to HIPAA privacy and security guidelines, or otherwise legally exempt from disclosure. If you have received this message in error, please notify the sender immediately either by phone (910.667.5307) or by return e-mail and destroy all copies of this message (electronic, paper, or otherwise).

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Charles Hackett
Sent: Monday, July 1, 2019 9:38 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [MCOH-EH] Worker's Compensation

** CAUTION: External Email **
Do not click links or attachments unless you recognize the sender and know the content is safe.

We report into HR at our system and oversee a population of approximately 15k employees at multiple sites.
Our EOHS department has historically managed every aspect of WC.
We use a TPA and are going through a RFP. We have had a nurse manager in the role of overseeing the TPA and interfacing with our employees when they are first injured and are involved through directing care to help with returning to work and a pretty vibrant modified work program.
Our management is questioning the value of a clinician in that role.

How is the management of workers compensation structured within your organization?
What role does your employee health/occupational health team play?
Do you have a dedicated manager and what is their background?
Where does risk fit into the overall scheme of things?
Do you have dedicate clinicians involved in your program?
Thank you
Charlie Hackett MD, MPH, Lifespan EOHS

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com<mailto:drjoe at meditrax.com>
---------------------------------------
When replying to a message, PLEASE delete all footers, and all messages to which you're NOT replying.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://mylist.net/archives/mcoh-eh/attachments/20190701/78f0d464/attachment.htm>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/jpeg
Size: 2400 bytes
Desc: image001.jpg
URL: <https://mylist.net/archives/mcoh-eh/attachments/20190701/78f0d464/attachment.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image002.png
Type: image/png
Size: 22884 bytes
Desc: image002.png
URL: <https://mylist.net/archives/mcoh-eh/attachments/20190701/78f0d464/attachment.png>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image003.jpg
Type: image/jpeg
Size: 5598 bytes
Desc: image003.jpg
URL: <https://mylist.net/archives/mcoh-eh/attachments/20190701/78f0d464/attachment-0001.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image004.jpg
Type: image/jpeg
Size: 7424 bytes
Desc: image004.jpg
URL: <https://mylist.net/archives/mcoh-eh/attachments/20190701/78f0d464/attachment-0002.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image005.jpg
Type: image/jpeg
Size: 4583 bytes
Desc: image005.jpg
URL: <https://mylist.net/archives/mcoh-eh/attachments/20190701/78f0d464/attachment-0003.jpg>

------------------------------

Subject: Digest Footer

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------
When replying to a message, PLEASE delete all footers, and all messages to which you're NOT replying.
When replying to a DIGEST message, please ensure your reply has a specific topic (not just Re:MCOH-EH Digest, Vol 251, Issue 101) so other subscribers can locate the thread in the list archives.


------------------------------

End of MCOH-EH Digest, Vol 254, Issue 201
*****************************************