Business Insurance RMIS Article

Comp, Benefits Exhibits Highlight Online Systems

May 14, 2001

by Lee Fletcher

ATLANTA-Several companies exhibiting at the Risk & Insurance Management Society Inc.'s conference in Atlanta were there to unveil and tout workers compensation and benefit management products.

Some of the most impressive products on display at the Georgia World Congress Center included online workers comp management systems designed to cut the high costs often associated with claims processing, as well as systems that aim to aid employers with managing comp cases and returning employees to work.

Em3 Corp., an online workers comp service provider, made its debut at the RIMS conference, held April 29 through May 3.

Em3, a unit of Addison, Texas-based Concentra Inc., is designed to help its customers streamline the workers comp process, reduce costs and improve outcomes.

The goal of Em3, said Dr. W. Tom Fogarty, senior vp and chief medical officer at the company, is to ``decrease the total cost of the case.''

Dr. Fogarty explained that, of the workers comp cases that used Em3 services, just 7% resulted in lost time claims, compared with 25% of cases that resulted in such claims when other processing methods were used.

Em3 President Jim Greenwood said large, multisite employers have lacked effective tools to address workers comp claims, resulting in poor communication, inefficiency and mismanagement.

Em3 incorporates a ``virtual provider community,'' made up of primary care physicians who focus on occupational medicine and work with physical therapists to manage cases and return injured employees to work, Dr. Fogarty said.

Under the system, all provider and pharmacy charges are submitted electronically, shortening the claims paper trail and cutting down on processing errors, Mr. Greenwood said.

``Although Em3 uses advanced technology, our goal is basic-ensuring employees receive high-quality health care delivered in an efficient, affordable and accountable manner, so they can return to productive work as soon as possible,'' Mr. Greenwood said.

Workers comp sales and service company ManagedComp Inc. attended the RIMS event to showcase its new ScoreCard program, designed to help employers control their workers comp losses.

Nancy A. Froude, recently named ManagedComp's president and chief executive officer, explained that ScoreCard's fivefold service consists of total injury prevention; prompt response to injured employees; channeling of injured employees to primary occupational providers; same-day reporting; and transitional duty, or ``getting an injured employee back to modified duty.''

The program's scorecards, which are provided at least twice per year, are designed to provide an ongoing assessment of an employer's workers comp program.

In addition, ManagedComp's E-Lert program provides risk managers with prompt notification that some aspect of the employer's program needs attention .

E-Lert ``gives the employer timely feedback. If you're at the end of the year or after the fact, it doesn't do anyone any good, because they're not able to have immediate influence on the outcome of the injury,'' Ms. Froude said.

Ms. Froude said the ScoreCard program also allows risk managers to provide senior management with regular updates on the success of workers comp programs.

ManagedComp is based in Woburn, Mass., and provides services to more than 5,000 clients in 44 states.

First Health Services, a health benefits company based in Downers Grove, Ill., unveiled its 4.0 Bill Review System at this year's RIMS conference. First Health's system filters claim information, streamlining the bill review process, according to the company.

First Health's vp of provider networks and bill review systems, David S. Correia of West Sacramento, Calif., explained that a client can access the information it needs at the time and in the way it wants through the product's clinical editing system.

Mr. Correia said that the review system, through secure Internet access, can help a large company ``to move bills around'' throughout the organization.

First Health handles more than 39 million claims each year.

``Because First Health manages all aspects of the bill review system, including training and technical support, clients benefit from decreased administrative costs,'' a company spokeswoman said.

A CIGNA Group Insurance product-CIGNA Short-Term Disability with Insured Long-Term Disability-provides a spectrum of services to employers that require disability management programs for both short-term and long-term disability cases.

The product is designed to offer clients a smooth transition from STD to LTD claims, to ensure claims are handled immediately, and to put employees in touch with the right clinical and occupational resources.

One of CIGNA STD/LTD's principal goals, said Tim Suchecki, vp of national sales for CIGNA IntegratedCare, is getting people back to productive work.

Cambridge Integrated Services Group Inc. unveiled its newest product, Cambridge Ovation, at the conference. Cambridge Ovation is a ``business intelligence'' system that provides Web-based data reporting capabilities to suit the individual needs of its clients, said Tracy D. Mock, Glenview, Ill.-based vp-marketing for Cambridge.

Ms. Mock explained that clients are able to ``drill down'' into data at various levels of detail, to sort the data and to create both on-demand reports and standard reports.

Cambridge President Stephen A. Eisenmann said that Ovation will provide Cambridge's clients with quicker access to claims data.

``The way this is designed, they can pick out certain parts. Whatever they want is at their fingertips,'' he said. Mr. Eisenmann said that Ovation allows its users ``to evaluate where their exposures are and design solutions in a more timely manner.''

Cambridge, a unit of Aon Corp., is a claims and loss-costs manager based in Cranbury, N.J.

Medical imaging network AnciCare PPO Inc. and Internet-based claims manager eStellarNet announced an agreement that will offer direct billing to workers comp payers for AnciCare's services. Miramar, Fla.-based AnciCare has over 1,000 freestanding magnetic resonance imaging centers.

The goal of the venture is to more efficiently provide medical imaging services to managed care organizations, insurance companies, third-party administrators and employers, said Bill Block, AnciCare's Syracuse, N.Y.-based vp of sales and marketing.