TPA’s / Case Managers

The HCN Solution

To solve the communications problems of the Work Comp/Occupational Medicine community, HCN provides a seamless interface to send sensitive patient medical information between silo’s electronically while remaining HIPAA-compliant. Through HCN, community members can also use secure instant messaging and access a broad suite of services that supports comprehensive case tracking and claims management.
HCN incorporates authentication, encryption, and authorization technologies to shield all patient data, no matter where it originates or where it resides. HCN Users can collaboratively manage cases regardless on which platform their data resides. In sum, HCN allows for the secure ‘interoperability’ of disparate practice management and claims management data systems from a single intuitive and easy-to-use Web-based interface. 

HCN Gives You Much Better ControlSo, from the Payer’s perspective, What do you want to know?: How are you going to control some of these costs? Well, you’re either going to create your own network like they did at Hopkins, pick out six doctors, say: “You’re going to see our people, you know how to take care of them, etc.  And we’ll pay you whatever the going rate is and what we want, we want to be linked in, we want to know what’s going on at all times.”   As a tool, HCN gives you much better control over the medical part of the claim.  And if you have that you can set up your infrastructure much better to handle your claim (i.e., you can track the claim very very closely).  For instance, there are certain pinch points in time, like at a month:

  • Where is this claim at a month?
  • Is this person losing time?
  • What are certain characteristics of the claim?
  • Should we get our attorneys involved just now?
  • What are the predictors?
  • Should we handle the claim in a different way?

HCN Offers Clear Benefits

  • Streamlines Processes
    • Provides improved business practices designed to streamline operations and administration while improving the efficiency of claims management
  • Gains Connectivity
    • Implements faster treatment planning and authorizations with all stakeholders in the HCN application enabling better communications while reducing waste, inefficiencies and errors
  • Improves Case Management
    • Improves stakeholder communications and allows faster transmission of data and information facilitating injured employees returning to work quicker, reducing indemnity liability
    • Embedded ACOEM guidelines or any other guidelines in the system.
  • Measures Outcomes
    • Delivers quality-of-care benchmarking among Providers/Practices
    • The ability of occupational Providers/Practices to return a higher proportion of injured workers to work early and shorten claims durations is a major factor influencing outcomes where, according to a recent study done by Johns Hopkins and the Louisiana Work Comp Corporation looking at healthcare Provider network vs. out-of-network results, the average frequency of lost workdays for a closed claim was reduced by 46% while the corresponding average cost of a closed claim was reduced by 38%.
    • Builds preferred Provider networks based on outcomes data linking the best care at the best cost.

Health Connections Networks | Copyright 2012