ICW Group 保险 Companies is the largest group of privately held insurance companies headquartered in California. 每年报价超过30亿美元, ICW集团是一家提供物业服务的运营商集团, 汽车及工伤保险. The company is recognized nationally as an industry leader in helping policyholders achieve fewer and less costly claims. 它也是高接触客户服务的主要倡导者, 特别是在支持受伤工人方面.
在工伤保险市场, patients approved for surgery are frequently left to fend for themselves without any nurse oversight or education. 这就产生了两个重大问题. First, it is not necessarily easy for patients to understand what care is required before, 手术中和手术后. 其次，谁负责安排病人护理并不总是很清楚. 医疗预约, post-operative care and required durable medical equipment are often arranged through the mixed efforts of patients and claims adjusters, 但这个过程对两党来说都是模棱两可的. 这两个问题会造成病人护理的延误和中断.
Surgery concierge was born out of the idea of making the surgical process easier for injured workers.
ICW集团也未能幸免于这一行业问题. Their claims adjusters commonly received late-afternoon phone calls from patients being released from the hospital, 经常要求运输回家或帮助确保家庭医疗设备. Patient support was largely reactive, creating challenges for both adjusters and patients. Realizing this was a huge opportunity to improve their customer experience while better managing outcomes, ICW集团与Mitchell合作寻找更好的方法.
“We really wanted to facilitate the surgery experience for everyone involved in the case,阿曼达·格兰杰说。, ICW集团亚博真人官方版APP负责工人赔偿索赔的副总裁. “首先也是最重要的, 我们希望通过确保患者事先做好准备来减轻他们的负担, 在手术中和手术后减轻潜在的焦虑. We also wanted our claims adjusters to be able to focus on examining the case rather than managing last-minute logistics. Accomplishing this two-pronged objective meant rethinking our customer support processes and engaging a creative partner with expertise to help streamline our processes.”
建设一条新的复苏之路
Mitchell worked with ICW Group to help identify areas for increased process efficiencies, then implemented a series of solutions that form the core of Mitchell’s Surgery Concierge service. 该服务提供白手套服务, 短期, 为受伤工人提供电话个案管理服务, 确保他们接受专业和个性化的护理, 在手术期间和之后，支持他们的健康和健康. 护士被指派帮助病人在术前导航 & 出院计划, 加快手术安排, post-operative treatment and therapies while utilizing preferred providers and monitoring care.
With Surgery Concierge, cases are automatically assigned to a nurse case manager at Mitchell. The nurses are trained to recognize and accommodate each patient’s unique support requirements, 为他们辩护, 并在手术过程中陪伴病人. 他们可以与患者协调调整手术日期. This helps reduce patients’ time away from work while also utilizing preferred providers to better manage costs. Surgery Concierge nurses can educate and guide patients through complex pre- and post-operative processes, 继电器恢复预期, 并在总体上缓解患者的担忧. 在手术当天, nurses ensure that transportation and other medical support requirements have been arranged so that patients can transition in and out of the hospital quickly. 外科礼宾部积极主动的病人支持也有利于理算员, who no longer worry about receiving late-day phone calls and scrambling to assist patients.
It is our responsibility as insurers to understand and navigate the complexities of workers' compensation.
推出这项新服务并非没有挑战. Determining the appropriate amount of time to keep a case open required some experimentation. It was important to ICW Group to provide enough time to build trust between the patient and nurse, 为病人提供安全和教育, 确保术后需求得到满足, and assess if any complications occurred that warranted additional clinical oversight. “确保患者获得积极的治疗结果是我们的首要任务, 这意味着给病人自由和空间来治愈,格兰杰说。. “It is our responsibility as insurers to understand and navigate the complexities of workers’ compensation. 通过这个项目, we were able to relieve patients of many logistical burdens associated with their treatment so that they can focus on their top priorities: recovery and good health.”
更好的支持 & 病人的结果
The development and implementation of Surgery Concierge service resulted in positive outcomes for all parties involved. 病人的压力更小，感觉得到了更好的照顾, 让整个手术体验更好. The burden on claims adjusters was also lifted as they knew patients were receiving expert support from nurse case managers who could resolve any issues on the medical care side.
The benefits of one-to-one advocacy programs like surgery concierge are undeniable.
工人的赔偿过程有时可能具有挑战性, but ICW Group’s commitment to improving the surgery experience resulted in a collaborative effort with Mitchell that has been well received by patients, 理算员和理赔经理. “The benefits of one-to-one advocacy programs like Surgery Concierge are undeniable,格兰杰解释道。. “We were able to realize our business and operational goals while giving patients a smoother, 更有利于手术恢复的途径.”