Safety National offers its policyholders CatCare, a Catastrophic Injury Claims program that provides real-time guidance from top experts in trauma, rehabilitation and other specialties, helping reduce errors and ensure that best practices are being followed. Our policyholders can take advantage of this program regardless of whether or not the Self-Insured Retention or deductible is ultimately breached. This partnership combines the claim management expertise of Safety National with the expert medical resources of Best Doctors providing a pro-active approach to achieve the best possible clinical outcomes on the most challenging and costly Workers’ Compensation claims.
CatCare Program Scope
CatCare Goals:- Ensure accurate diagnoses and highest standard of care
- Make sure the patient gets the right care, at the right time, at the right facility at every stage of recovery
- Early identification of critical medical issues and potential problems
- Reduction or elimination of costly, long-term medical surprises that often arise in catastrophic cases
- Input from nationally-recognized trauma clinicians within 1 business day of referral
- Case management by nurses experienced in catastrophic injuries
- Ongoing review and analysis by world-class specialists including expert physiatry consultation during the rehabilitation process
- Understanding the “big picture” versus obtaining fragmented information
- Continuing communication between the claims team, nurse case manager, and Best Doctors clinicians
- Real-time updates on progress through the Best Doctors secure web reporting tool
- Monthly reports identifying outstanding medical issues and recommendations
Case Referral Criteria
All current Specific Excess and Large Deductible Workers’ Compensation policyholders will be eligible, regardless of Self-Insured Retention or deductible amount.
Eligible Injury Types:- Traumatic Brain Injury
- Spinal Cord Injury
- Major Amputation
- Serious Burns
- Serious Multiple Trauma (single employee)
Safety National will work with the policyholder and TPA to determine whether or not a claim meets one of the definitions of a Catastrophic Injury Claim.
Claim Reporting and Fees
To be eligible for the program, a Catastrophic Injury Claim must be reported to Safety National within three business days of the accident. If a Catastrophic Injury Claim meets the reporting requirement, Safety National will pay 100% of the cost of the first month of Best Doctors service, regardless of whether or not the claim ultimately exceeds the Self-Insured Retention or deductible. The first month of this service is often the most expensive for the policyholder.
This program is completely voluntary. Coverage terms under the applicable policy will not be affected should the policyholder decline Best Doctors services.
For more information on Safety National and Best Doctors CatCare program please visit us at www.safetynational.com or contact Sherri Hickey, Medical Management Director at catcare@safetynational.com or by phone: 866-762-2559.
What is Ask Best Doctors?
Ask Best Doctors is a pro-active, non-adversarial, consultative medical review by a Best Doctors specialist for injured workers at high risk for adverse developments in their medical condition. Based on the specific needs of the case, Best Doctors will select one of its top experts to review the injured worker’s current diagnosis and treatment plan. Safety National offers this program to all current Specific Excess and Large Deductible Workers’ Compensation policyholders, regardless of Self-Insured Retention or deductible amount.
The Ask Best Doctors program includes:
Phase 1
- Review of case
- Conference call with claims team and
- Final report
If the reporting requirement is met and the claim is determined to be appropriate for the program, Safety National will pay 100% of all Phase 1 fees.
Phase 2: Extended ABD
- Additional testing and evaluation if needed
Phase 3
- Implementation of specialist’s recommendation
Changing Outcomes for the Better
Not every Ask Best Doctors report will recommend a change in diagnosis or treatment plan. While confirmation of an appropriate diagnosis and treatment plan by the Best Doctors Expert is of great value, the goal of the program is to change an injured worker’s medical outcome for the better. The Ask Best Doctors Expert report will not be used to deny care to the injured worker, interfere with the treating doctor – patient relationship or compel any change in the treatment plan. This process of open communication should assist the injured worker to make informed decisions about his or her medical care.
Case Referral Criteria
Case referrals routinely involve one of the following medical circumstances:
- Request for second spinal surgery (i.e. laminectomy or fusion)
- Request for spinal cord stimulator or morphine pump
- Early onset of Chronic Regional Pain Syndrome (CRPS) or Reflex Sympathetic Dystrophy (RSD)
- Pharmacy review
- Validation of treatment
- Chronic Pain Intervention
To be eligible for the program, a claim must be reported to Safety National in a timely manner allowing sufficient lead-time for a meaningful review by the Ask Best Doctors program. Safety National will determine if a referral to Ask Best Doctors is appropriate. Utilization of this program by the policyholder is highly recommended but is completely voluntary. Coverage terms under the applicable policy will not be affected should the policyholder choose not to utilize the Ask Best Doctors services.
For more information on Safety National’s Ask Best Doctors program please visit us at www.safetynational.com or contact: Sherri Hickey, Medical Management Director at askbestdoctors@safetynational.com or by phone 866-762-2559.
