Paladin Introduces Effective Case Management Strategy

Paladin, a managed care services provider, guarantees their new service suite will substantially improve results for three involved groups: carriers, policy makers and carrier. With the new plan, Paladin boasts that patients will return to work 11 percent more quickly; on average, the program says it can reduce claims costs by a margin of as much as 8 percent.

The company's chief operating officer is Jeffrey D. Miller, who holds that a closer amount of attention to treatment and requests for medication not only increases the likelihood of a positive outcome for treatment recipients, but in the same stroke reduces the costs that insurance brokers incur, per-case. Physician Case Management service allows for claims examiners and doctors to work closely with one another other to make decisions regarding any case that represents more than a total of six weeks' worth of missed work time.

A prevalent model for care management is currently known as "legacy indemnity." Legacy indemnity dictates that nurses and claims examiners discuss the medical aspect of an insurance claim. Should any questions arise, a nurse will in turn defer to the opinion of a physician. Not only does this step needlessly slow claims processing, but lengthens the amount of time a patient must wait in order to receive care. By shortening this window of time, patients recover more quickly and end up saving their insure brokers money.

Paladin's approach, equal parts novel and intuitive, calls for the direct, automatic and immediate involvement of a physician during the very beginning of the claims process. When a claim gets moving more quickly in this way, the long-term returns are considerable. Marc Miller, M.D. and senior VP and chief medical officer at SeaBright Holdings, explains that the development of the Physician Case Management service represents a veritable breakthrough in case management strategy.