Medical Management Services

At Alaska National, we see the management of the medical aspect of workers’ compensation as a critical factor in determining the final outcome of an injury.

Quickly responding to an injury with the best medical care available is the first step in accident response efforts. Responding quickly helps minimize the effects of the injury, allowing early return to work, and eventual recovery without permanent disability. In addition, responding to the worker’s needs quickly and professionally sends a strong message that the employer cares and wants the best for their workers. Quickly responding also positively impacts the employer’s operations and costs by minimizing the re-scheduling of work, the finding of replacement workers, and many of the other secondary complications of on-the-job injuries.

Alaska National Insurance Company in cooperation with Medcor, has developed a Workplace Injury Hotline that can be called for immediate medical assistance following an on-the-job injury. The Workplace Injury Hotline is staffed 24 hours a day 7 days a week with specially trained nurses who will assess the injury and provide treatment recommendations to the injured worker. Often these nurses are able to help resolve many injuries with self-care, however, a nurse can also help identify injures that may be more serious than they first appear, and timely direct the injured worker to the level of care that is needed.

However, it should be noted that providing the best medical care is not the only necessary step in effectively managing medical services.

At Alaska National, we have developed a company-wide, fully integrated medical management services program. Alaska National’s Medical Management Services program assures that injured workers not only receive the best care available, but also the most appropriate care.

Where allowed by jurisdictional requirements, Alaska National has implemented utilization review programs that help determine which treatment recommendations are appropriate for the injury in question, and suggest alternatives when current treatment is not appropriate. Inappropriate care is not likely to improve the worker’s condition, and may serve to prolong the recovery process. If needed, our reviewers can discuss options with the treating physician, and agree upon a treatment plan designed to maximize the injured worker’s recovery.

Alaska National has found that complex, serious cases benefit from intervention by a nurse case manager. Nurse case managers have personal contact with the injured worker, facilitate communication with the treating doctor, and offer to help resolve medical questions. In many cases utilizing a nurse case manager speeds recovery and eventual return to work. The nurse case manager also benefits from having access to our physician networks and utilization review programs so that their activities are coordinated and consistent with efforts already undertaken.

Last, but certainly not least, making sure the costs of medical treatment are properly managed is another important aspect of Alaska National’s Medical Management Services program.

At Alaska National, every bill received is reviewed to make sure it is properly coded and supported by medical reports detailing the services provided. Every charge is then compared to the applicable medical fee schedule and adjusted accordingly. Finally, where allowed, further reductions are taken when the treatment provided is within a contracted Preferred Provider Organization.

As part of Alaska National’s integrated medical services program, all prescription drug requests are reviewed for appropriateness, dosage and potential abuse, assuring injured workers receive the treatment they need, and in amounts appropriate to their condition. In addition, all requests for Durable Medical Equipment are reviewed, and alternatives to outright purchase are often identified that helps keep costs for use of these temporary aids to a minimum.

In California, Medical Provider Networks provide an additional means to better manage the course and cost of claims following injuries at work. These networks provide all medical treatment to workers injured on the job, and, subject to an appeals process, will do so for the life of the claim. These networks have proven to have a significant impact on workers compensation costs, and the rapid recovery and return to work for injured workers.

At Alaska National, we have partnered with CorVel Corporation to implement our medical services program with bill review services, a prescription drug program and Corvel’s California Medical Provider Network. Corvel Corporation is a national provider of leading-edge managed healthcare solutions to employers, third party administrators, insurance companies and government agencies.

For more information about CorVel, please go to www.corvel.com.

Click here for more information about the California Medical Provider Network.