SeaBright Holdings, Inc.’s subsidiary, SeaBright Insurance Co., has launched a new managed care new program called “BrightCurePDQ”, which stands for Physician-Directed Quality.
Starting in June, upon notice of loss, SeaBright will employ a more medically-oriented claim model using doctors to actively manage the medical aspects of selected lost time claims. SeaBright identifies these claims using its predictive modeling techniques. The predictive model identifies, early in the life of a claim, those injured employees that represent the greatest cost potential and most serious return to work challenges. Starting on day one, SeaBright’s occupational medicine and orthopedic physicians will review, authorize, and direct the medical treatment and requests for pharmaceuticals, such as Class II narcotics, which are significant cost drivers of medical claim costs. The company’s goal is to smartly deliver quality and appropriate cost-effective medical care to return the injured worker back to work expeditiously.
SeaBright’s claim examiners will continue to manage the non-medical aspects of these claims, and will work in partnership with the physicians to drive the claim towards a timely and successful closure.
SeaBright is launching this program in response to rising medical care costs for workers’ compensation claims. According to the Workers’ Compensation Insurance Rating Bureau of California, nearly 69 cents out of every claim dollar were spent on medical benefits in accident year 2009.
BrightCurePDQ is available only in California at this time, but the Company expects to expand the program in selected jurisdictions nationwide by year-end.
Source: SeaBright Holdings
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