Taking Heart in Workers Comp
Monday, April 11, 2016 | 417 | 0 | min read
Taking Heart in Workers' Comp
Genex honors three difference-making case management professionals through new Heart of Case Management Award
WAYNE, PA – April 11, 2016 – Genex Services today announced the winners of its inaugural Heart of Case Management Award. The new award is designed to recognize case managers' expertise by promoting their excellent work at Genex Services, one of the nation's largest providers of workers' compensation managed care services.
Genex's case managers are highly regarded in the industry for going above and beyond their traditional job description by employing their unique experience, empathy and expertise to improve the lives of thousands of injured workers each year. Their everyday stories are truly inspirational but often go unheard. Genex introduced this new award to spotlight exceptional field, telephonic and catastrophic case management.
Case managers were nominated by their branch managers and judged on the following criteria: specialist, excellence, adaptability, trusted, influential communication, and outcomes. Judges selected three winners whose efforts in highly involved cases made a significant impact on their claimants.
Field Case Management
Kim Price-Benham, RN, CCM, Troy, MI Branch
When a patient was having trouble with post-op recovery from a hand injury, Price-Benham worked with a top hand specialist to secure a diagnosis of reflex sympathetic dystrophy (RSD). They then established a definitive treatment plan which helped ensure the worker received appropriate and specific hand therapy and bracing, allowing him to be released to full duty, pain-free, with no restrictions within 12 weeks of the RSD diagnosis. Price-Benham's efforts helped the injured worker avoid a year of injections and pain clinic treatments, returning a valued employee back to his workplace with considerable savings on the claim and a return on investment (ROI) of 8.5 to 1. The efficient and effective return-to-work protocol allowed him to earn a new promotion that wouldn't have been available had he stuck to the original yearlong treatment plan.
Catastrophic Case Management
Nicole Hurley, RN, BSN, CDMS, Charlotte, NC branch
When a workplace explosion blasted an employee down an elevator shaft causing life-threatening injuries, cataracts, and a traumatic brain injury, Hurley diligently managed two years of long-term rehabilitation and kept communication current with providers and family. Even though the injuries he experienced were catastrophic, Hurley's efforts allowed the injured worker to be discharged from all care except his eye provider. He is no longer taking pain medication of any kind, and his medications are minimal based upon his initial medicinal regimen. Hurley ensured the injured worker received the right care at the right time which also eliminated significant delayed treatment costs.
Telephonic Case Management
Mare Novess, RN, CCM, Midwest UM branch
After a 55-year-old truck driver sustained a leg crush injury, Novess used her clinical expertise to explain the anatomy of his injury and hematoma diagnosis, discussed the surgeon's treatment plan and provided patient education on the surgery, follow-up care, expected post-op pain/discomfort and medication. In addition, Novess' empathetic nature also shined through during the course of treatment when the patient's wife became extremely ill and the injured worker expressed concerns about missing PT and occupational clinic appointments so he could be with his wife. Novess assured the claimant, notified all parties and rescheduled appointments in a prompt and efficient manner. Due to Novess' diligence and communication skills, the injured worker completed the treatment protocol, avoiding costly treatment delays, and was released to work earlier than the guidelines projection.
More in-depth information on each case management story can be found at www.genexservices.com/fromtheheart
About Genex Services, LLC
Genex Services (www.genexservices.com) is the trusted provider of managed care services enabling workers' compensation payers and risk managers to transform their bottom lines. Genex is a managed care leader with more than 2,900 employees and 47 service locations throughout North America. The company serves 381 of the Fortune 500 companies as well as the top workers' compensation and disability carriers and third-party administrators in the U.S. In addition, Genex is the only company that delivers high-quality clinical services enhanced by intelligent systems and 360-degree data analysis. The company consistently drives superior results related to medical, wage-loss, and productivity costs associated with claims in the workers' compensation, disability, health care and automobile systems.