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Case Management Advisor

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  • Workers may try to hide their depression

    Depression isn't typically the first complaint a worker presents to their occupational health professional. In fact, an employee is likely to conceal this from you.
  • Asking post-acute providers for free services

    When patients do not have a payer source for the post-acute services they need, you may be putting providers at risk of fraud if you work with them to provide free or voluntary services, warns Elizabeth E. Hogue, Esq.
  • Collaboration between providers, patients, payer helps reduce gaps

    A collaborative effort between Keystone Mercy Health Plan and local hospitals to provide care coordination for Medicaid members is helping reduce health care gaps and emergency department and inpatient utilization.
  • Know penalties for privacy reg violations

    The unauthorized release of employee health information can result in civil, and sometimes criminal, liability under both federal and state laws. For example, covered individuals under the Health Insurance Portability and Accountability Act (HIPAA) face civil fines ranging from $100 to $25,000, depending on one's level of intent. Criminal penalties include fines ranging from $50,000 to $250,000 and imprisonment of up to 10 years.
  • Do depression screening, or face lower productivity

    If an employee is absent more often and supervisors report an impaired work performance, suspect depression.
  • TB: Stay vigilant as drug resistance spreads

    Tuberculosis has continued to decline in the United States even as parts of the world struggle with the growing burden of multi-drug-resistant strains.
  • PAPRs end frustration of fit-test failures

    At DuBois (PA) Regional Medical Center, employees were failing N95 fit tests in alarming numbers. In the cardiology department, about 46% of employees failed fit-tests even after trying a variety of models and sizes. Things weren't much better in anesthesia (35%), cardiovascular ICU (34%), or the emergency department (26%).
  • Is wellness data too dismal to share? Don't be so sure

    Imagine showing higher-ups statistics indicating that thousands of dollars were spent on a weight loss program you implemented recently, but unfortunately, none of the participants actually lost any pounds. Or would you be eager to spread the news that only two employees attended a diabetes lunch-and-learn?
  • Rewarding workers for lack of injuries is risky

    Have you learned that back injuries are the top cost drivers in workers' compensation cases at your workplace? Imagine the impact of giving incentives to various departments if zero injuries are reported within a certain time period. Or then again, maybe not.
  • Use team approach to ID workers' comp costs

    Consider yourself a member of the "workers' compensation team" as a strategy to reduce costs, says Mary (Penny) B. Nicholls, RN, CCM, COHN-S, a disability consultant with Alabama Power Company in Birmingham and a member of the advisory board for the Deep South Center for Occupational Health & Safety at the University of Alabama at Birmingham.