June 2014 – Too much ‘medical guidelines’

The industry of providing medical guidelines has been around for many years, and it’s an important part of the claims management process to understand the depth of the medical issue that is diagnosed on a claim. However, there are a couple of reasons why this approach is flawed. Recovery rates are influenced by many other factors on a claim: age of claimant, occupation, co-morbidities, etc. Some of the guidelines take a few of these factors into consideration, but this is only a fraction of the whole picture.

We have found over the years that obscure data items have an influence on recoveries.

How about ‘distance to care provider’ or ‘promotion prospects’ both are non-medical. There are many other examples, without this information, we have a very restricted picture of the employee’s likelihood of returning to work. Remember that claim duration has very little to do with the human bodies healing time…. To understand more about this fascinating topic please contact us at info@claimlab.org


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