Virtual Case Discussions Enhance Case Outcomes in Workers’ Compensation Claims

Workers’ Compensation Claims: Challenges and complexities

Workers’ compensation claims are inherently complex. Often, prolonged claim resolution occurs due to frequent disputes between injured employees, insurers and employers. Arguments regarding severity of injury, appropriate treatment, and even time of recovery add to the overall inefficiencies, which can be an incredibly frustrating process for all involved.

What is BICMD (Best In Class MD) Roundtable Service?

Best In Class MD (BICMD) is your best resource to support your team in making effective claim decisions. Our top 1% of medical experts can help you navigate workman’s compensation claims, make them less complex and give you clear, clean-cut answers. Our MD Roundtable Service offers an innovative solution to evaluate workers’ compensation claims by doing the following:

• Expert physician involvement: A physician, who is a Board-certified specialist, reviews the medical records and imaging
• Virtual case discussion: A 30-45 minute telehealth visit (up to 10 participants) offers an interactive session with all stakeholders.
• Optional written report: Provided upon request
• Real-time collaboration which streamlines communication between all parties.

Less Red Tape for Workers’ Compensation Claims:

We have increasingly noted that there can be a disconnect between insurance companies, employees, employers and treating physicians. It became obvious that we needed better collaboration in order to arrive at faster claim resolution. Our goal is to facilitate a system where the employee gets back to work with appropriate diagnosis, treatment and rehabilitation, without unnecessary or costly delays. BICMD brings together the stakeholders in the game, by getting everyone on the same page and offering unbiased medical solutions.

How can a virtual case discussion by BICMD help with workplace claims?

There are many benefits to our virtual case discussion, first and foremost it involves a neutral party or mediator for the Workers’ compensation case. We offer only expert medical opinions that can do the following:

• Improve Decision-Making:
  • Access to expert medical opinions ensures accurate assessment of injuries and treatment plans.
  • Early intervention with an expert can reduce costs by preventing unnecessary (often over-prescribed) surgeries or procedures.
  • An accurate timeline for treatment and recovery.
• Increase Efficiency
  • Real-time discussions eliminate both the paperwork shuffle as well as travel time. Getting everyone together in one setting is simplified by our secure, virtual discussion.
  • Delays in diagnosis, treatment and insurance claim payment are avoided with a clear-cut analysis and treatment plan.
• Cost Savings
  • We can help with the avoidance of unnecessary treatments and prolonged claim duration.
  • We have proven to reduce legal disputes through clear, expert-backed recommendations.
• Enhanced Stakeholder Communication
  • Our MD Roundtable gives all parties an opportunity to ask questions, share information and gain clarity. This may include:
    • Insurance Claims Adjusters
    • Employers
    • Employees or Workers
    • Case Managers
    • Nurses
    • Treating Physicians
  • Promotes trust between all roundtable participants.
• Better outcomes
  • We help ensure that appropriate diagnosis and treatment recommendations are made.
  • The MD Roundtable helps improve the confidence of the claimant through expert evaluation and validation of medical opinions.

How BICMD saved a workers’ compensation claim thousands of dollars:

In a real-life example of a recent workers’ compensation claim that came to our MD Roundtable, BICMD was able to save everyone involved time, money, and unnecessary surgery.

The Injured Worker (IW) was working at a high-end chain restaurant as a server.

One evening, she accidentally slid on a wet floor, caused by the rain, while carrying a tray of drinks. She caught herself before falling, but in doing so, felt something pop in her knee.  Her pain was immediate and she had to have another server finish her shift. The employer noted that the IW was limping, and had her ice the injury, then sent her home.

A day later, the knee was still painful. Ultimately, the IW went to the employer-approved emergency clinic. X-rays were ordered, but no breaks were visualized. The clinic sent her to a physician who ordered an MRI.

The insurance company then received a report that Susan needed a total knee replacement and asked her to get a second opinion. The next physician said Susan actually had a hip injury, along with a knee injury and requested an MRI for her hip.

Given concerns about inappropriate diagnoses and errant work-ups, the Employer reached out to the insurance company, who denied the second MRI and the entire injury claim. This denial heightened the employee’s dissatisfaction. Finally, the insurance company reached out to BICMD for our assistance in better understanding the nuances of the clinical injury.

In a 30-45 minute MD Roundtable, a BICMD Hip and Knee Surgeon was able to share our expert opinion and show the results of the knee MRI and as well as review the initial Xray of the hip. The expert gave his assessment that the IW might be able to delay a knee replacement with a combination of injection and physical therapy and that the hip pain was compensation from the knee. After 2 months of physical therapy and a knee steroid injection the IW was able to returned to work and through our mediation were were able to help Susan get back to work without surgery.

Why Choose BICMD for Virtual Case Discussions?

We can save interested parties a lot of time, aggravation and unnecessary spend, by advising appropriate medical care through our extensive network of board-certified physicians. We have a proven track record in improving claims and outcomes.

At BICMD, we are committed to impartiality and evidence-based recommendations.

Workers’ Compensation Claims Savings:

If you are an employer, workers’ compensation claims carrier or an employee facing the daunting process of a workers’ compensation claim, you may benefit from contacting BICMD for an unbiased 2^nd opinion. Our MD Roundtable will enhance your claims management process, save money and help employees get the appropriate, timely care they need. Our experts are board-certified and have a proven track record of recommending the best care for the patient’s specific injury.