Claims Handling
Our Claims Case Managers (CCMs) collaborate closely with employers, injured employees, and healthcare providers to ensure the swift and essential treatment of injured workers. This facilitates a speedy recovery and a prompt return to work following any work-related injuries.
Our experienced CCMs bring years of technical expertise in managing workers’ compensation claims. This expertise enables them to comprehend the intricacies and effectively communicate them to both injured workers and employers.
Cardinal Comp’s claims team includes highly skilled bilingual CCMs fluent in both English and Spanish. This capability allows for clear and effective communication with a diverse client base, building trust and understanding throughout the claims process. By bridging potential language gaps, the team provides personalized support, speeds up claim resolutions, and enhances the overall experience for clients and their employees. Cardinal Comp remains committed to delivering exceptional service and making sure every individual feels heard and supported.
Additionally, our vast network of medical providers and vendor partners facilitates the smooth coordination of medical treatment, resulting in enhanced efficiency and significant cost savings.
What Makes Our CCMs Stand Out?
Manage less than 90 claims per adjuster
Prioritize swift initial contact and maintain regular, ongoing discussions with injured workers, status updates with employers, and outline next steps
Engage in daily interactions with Underwriting and Loss Prevention teams
Facilitate modified work in alignment with the employer’s return-to-work program
Leverage our bill review network, yielding an impressive average savings of 57% below billed charges
Harness our pharmacy network, resulting in an average savings of 45% below fee schedule
Cost Containment Strategies
Outcome-Based Claims Management
BILL REVIEW
Average savings of 57% below billed charges; 11% below WC fee schedule. PBM Integration increased medication savings from 42- 47% below fee schedule.
IN-HOUSE EXPERTS
Every facet of medical management is supervised by in-house specialists, including the medical director, claims case managers, nurse case managers, and the bill review department.
LITIGATION MANAGEMENT
By restricting the caseload for legal counsel and taking proactive steps to oversee litigation expenses, we effectively decrease claims expenses and shorten the duration of claim files.
PREDICTIVE ANALYTICS
ODG offers evidence-based medical and return-to-work guidelines tailored to specific diagnoses. Additionally, we provide comorbidity assessments and reserve calculators based on NCCI data.
When an Injury Occurs
Our employers and injured workers have access to medical assistance 24/7 through our telephonic medical triage and telemedicine network.