CompManagement from HealthLink Printer Friendly

Key Features
  • Focused PPO Network
  • Discounted Fee-for-Service Arrangement
  • Guided Referral Authorization
  • Telephonic Case Management
  • Claim Coordination and 24-hour Preprocessing
  • Client Management Reports

CompManagement from HealthLink helps employers manage the financial risk associated with work-related illness and injury. HealthLink’s goal is to provide access to participating physicians, hospitals and other occupational medicine professionals.

Focused PPO Network
CompManagement is a focused PPO network. Contracted physicians are experienced in treating work-related illness and injury. Should an illness or injury require services beyond the scope of the initial physician’s area of expertise, the injured employee will be guided to appropriate specialists for treatment. The CompManagement network includes local physical therapy, rehabilitation centers, work-hardening centers and hospitals for treatment of severe and second/third shift work injuries. Contracted physicians and facilities have met HealthLink’s credentialing standards. CompManagement PPO participating physicians and facilities have agreed to accept discounted rates of reimbursement for services.

Utilization Review
HealthLink’s staff consists of licensed registered nurses, physician reviewers and administrative personnel provides CompManagement case management services. Components of the standard CompManagement program include Guided Referral Authorization and Telephonic Case Management.

Claims Coordination and 24-Hour Preprocessing
24-hour preprocessing automatically identifies any claim duplicated between HealthLink’s Group Medical and Workers’ Compensation systems. This electronic interface reduces the possibility of paying twice for the same episode of medical care and ensures funds for payment come from the proper source. The system helps reduce fraud or error and promotes timely resolution of payment disputes.

Client Management Reports
CompManagement from HealthLink provides clear, meaningful documentation of Workers’ Compensation cases at every stage of treatment and rehabilitation until a case is closed. Reports also document physician/facility usage and charges as well as total network savings.

Effective Managed Care Services
Providing a fully integrated system of quality, cost-effective managed care services is our highest priority. We believe active collaboration with purchasers and benefit administrators provides the best results. The following is the standard distribution of responsibilities. The actual assignment of these functions may be customized according to the needs of the insurance payor/employer.

    HealthLink
  • Network Management
  • Telephonic Case Management
  • Guided Referral Authorization
  • Program Installation
  • Claims repricing
  • Online directories
  • Toll-free customer service
  • Client reports/meetings
    Insurance Payor
  • Coordination of medical/disability management decisions
  • Eligibility determinations
  • Medical/disability payment decisions
    Employer
  • Eligibility management coordination with claim payor/benefit administrator
  • Right to direct medical care to selected physicians and facilities (MO)