Full Medical Claims Management
Windley Ely’s most comprehensive program offers all the services in the Comprehensive Claims Management program, combined with a full complement of Windley Ely’s medical team to optimize return to work outcomes.
How It Works
Windley Ely’s Nurses, Occupational Physicians and Specialists monitor the medical care of injured employees to ensure accurate diagnosis and appropriate treatment. Occupational Physicians and/or Specialists help establish Full Return to Work (FRTW) and Modified Work goal dates based on current medical information obtained from your employee’s attending physician and other care providers.
The Registered Nurse regularly (at least weekly) communicates with the employee and the various treatment providers throughout the life of the claim, to help ensure that established recovery guidelines are met. Any delays in recovery trigger a Medical Team Review (MTR) through which our doctors determine the best medical intervention needed to promote recovery to the FRTW or Modified Work goal date.
Windley Ely’s multi-disciplined approach integrates the expertise of our team of medical professionals with that of the employee’s Attending Physician, to help ensure injured employees receive the best possible medical care and oversight. Our in-house medical team yield a significant advantage when challenging Time Loss, preparing medically substantiated Cost Relief applications and medically supported legal appeals.
Consistent medical management and intervention starting at the “Point of Injury” has proven to be the single most effective tool in reducing paid claim durations while improving the care of injured employees.
Full Medical Claims Management is frequently bundled with our Nurse Triage program.
How can Nurse Triage help your organization?
Minimizes the need for employees to seek 3rd party medical care in cases where it is medically deemed unwarranted/inappropriate.
Reduces the number of medical aid, restricted work and time loss claims incurred when an injured employee sees a doctor for a minor injury that could otherwise have been maintained as a straight forward first-aid claim with nurse follow up/intervention.
Helps ensure that the employee is directed to timely medical care when required. Too often employees refuse or delay seeking initial medical attention. Without early Nurse intervention these claims can escalate into more serious injuries.
Eliminates the burden on supervisors who otherwise need to determine whether or not to direct the employee to medical and under what circumstances.
Who uses this service?
Employers in physically demanding industries
(e.g., Oil & Gas, Construction, Forestry, Healthcare etc.)
Higher wage businesses
Higher WCB Base Rate/Assessment industries
Higher severity injuries
Privately owned companies
Windley Ely is able to improve your workers’ compensation claims management by striving to outpace our peers in 5 key areas:
Unmatched Service
Challenging Entitlement
Minimizing Lost Time
Cost Relief and Cost Transfer
Account Management
We take a holistic approach to workers’ compensation, with a sharp eye for cost management and workplace productivity. Our end-to-end managed service model provides superior claims management at a lower price than your current solution.
