Upload
bill-zimmerman
View
306
Download
1
Embed Size (px)
DESCRIPTION
National Disability Management Firm Specializing in Woker's Comp
Citation preview
888.853.6412www.kingstree.net
900 West Valley Road, Suite 300Wayne, PA 19087
ote fRom KingStReenThe Kingstree Group, Inc., a disability management firm, was founded with a single-minded drive, to deliver a better service than our competitors and to save our customers money. We do that every day, skillfully, efficiently and consistently.
At the Kingstree Group, the employer is our customer. Our proprietary medical service delivery platform focuses on achieving positive outcomes and significant savings for our customers.
Our commitment to our customers allows them to manage the cost of their risk without jeopardizing the integrity of care required for their employees.
The Kingstree staff comes together with a variety of uniquely qualified backgrounds and wealth of experience to deliver a service model that is unmatched by our competitors. We understand the need for a custom fit and provide it. We know that “customer service” is not just a buzzword and deliver it. We believe in our programs and people and it shows.
We invite you to call us to find out how to make the Kingstree difference work for you.
“Medical drives Indemnity”…It’s become a catch phrase in managed care. We at the Kingstree Group Inc. however understand the impact
on you, your injured worker, your bottom line.our triage team:
The first step in setting the course for claims resolution Identifies the issues and develops the most expeditious plan for the claim from day one We do it every day, every claim, expertly, seamlessly and efficiently
Predictive modeling“20% of claims represent 80% of the costs”
Science, evidence based questions were identified to measure claim cost and longevity Psychosocial indicators are inherent in the process and show predictive patterns with certain claim outcomes Early identification allows early intervention for medical resolution Predictive medical data mining means better medical outcomes and thus better claims outcomes
The 80/20 rule demystified.
Triage identifies the issues and our telephonic division establishes the plan to resolve them, expertly and seamlessly.
Immediate identification of and plan for medical and claims issues Reserve detailing that saves you money Compliance to recommended course of action Return to work timeline, clearly and concisely detailed and achieved
Exceptional communication… a pre-requisite.
telephonic Disability management
triage
field Case management
network management
oRK SolutionSW
The most difficult balance to achieve is the transition from telephonic disability management to the field.
Field team staff ready when and where needed Manage the cost of the risk without jeopardizing the integrity of the care needed Quick response in coordination with telephonic counterparts – seamlessly Clear, concise, goal focused communication with your entire team
Creatively and efficiently managing care… expected.
Creative implementation of specialty networks that cut your costs and streamline targeted, specialized care for your injured worker.
Increased network penetration Exceptional treatment results – consistent follow up Focus on results…increased productivity and decreased costs
Finding the “right” provider… a must.
• • •
• • • •
• • • •
• • • •
• • •
Short/long term Disability
fmlA
Kingstree works directly with internal HR, General Counsel or other designees to structure the optimal program.
Data analysis to identify appropriateness of the leave request Seamless coordination of information Clear, fast and comprehensive reports
Determining appropriateness… critical.
Kingstree understands the policy driven issues that drive your costsand endeavors to resolve them.
Analysis of the policy constraints so that only appropriate steps are taken Customized programs based on the policy constraints and claim specific issues Custom plan with report to resolve/mitigate the issues
Policy constraints… a reality.
At Risk Claims
When questionable claims/treatment are an issue, Kingstree will immediately identify high risk medical issues and behaviors.
Clear multi-option strategies are outlined Unnecessary or inappropriate claims are swiftly identified
Ability to see the “red flags”… essential.
K-Biz, the proprietary internal web application for the Kingstree Group Inc.:
• Developed to increase the speed of information gathering to manage claims
• Designed to create a central information point for multiple users to handle medical/claims data seamlessly; internally or remotely
• Utilizes a scripting language that allows for flexibility of technology integration
• System modification can be done with less cumbersome programming and thus more efficiently
• Standard and customized reporting for our clients
• User friendly environment• Secure data storage
KBIZour experience produces superior results...
our technology provides superior performance
• •
• • •
• • •
goal: implement an innovative, customized strategic medical management platform that will directly reduce workers compensation losses. this results driven approach will dramatically impact your claims.
Your Cost Controlled
Average indemnity Costs: Kingstree’s collaborative approach on early medical and return to work strategies reduce average indemnity costs up to 50% per claim.
Average medical Costs: Kingstree’s collaborative approach involving ongoing medical management has proven to reduce medical utilization and duration. Average medical costs on indemnity claims are reduced by
up to 50% per claim.
Identify Hidden “Benefit Delivery” Costs: Benefit Delivery services such as out of network medical management and legal related costs can be up to 25% of the total loss. Drive down average costs per claim
up to 20% for benefit delivery services and target proactive management strategies.
medical/indemnity Claim Split: Early claim and medical management initiatives reduce claims paying lost time benefits up to 25%.
Claims Closure Rates: Early medical and return to work strategies increase the percent of claims closed up to 20%, reducing both medical and indemnity costs on high dollar claims.
CUSTOMER THE TEAM ADJUNCT TEAM
ULTIMATE CONTROL CLAIMSADJUSTER
BROKER / AGENT
KINGSTREE Claims Data Management
Pro-tailored Provider Panels
Specialty Networks• Pharmacy Benefit Managers• All therapies• Durable Medical Equipment• Drug testing - post accident - medication compliance• Language Services
HOW IT WORKS
ingStRee SeRViCe DeliVeRY PlAtfoRmK
•
•
•
•
•