1. Presented by Charlotte Price August 12, 2015

4.  Development of Provider Panels ◦ Quality of care and reputation in their field of specialty.  Medical Bill Review & Re-pricing ◦ All medical bills submitted to carrier are reviewed and re-priced according to the states’ workers’ compensation medical fee schedule.  Pharmacy Program ◦ Partners with Helios as our preferred provider of pharmacy benefit management services for workers' compensation claims.

5.  Physician dispensing: The practice of physicians providing medication directly to patients increased from 6% of total workers’ compensation drug costs in 2003 to 17% in 2011(NCCI).  Compounded drugs: Compounding is a practice in which a licensed pharmacist or a licensed physician combines, mixes, or alters ingredients of a drug to create a medication tailored to the needs of an individual patient. Practice increased by more than 125% from 2012 to 2013 (Express Scripts).

6.  Aggressive Return to Work  Consistency in Treatment Plan  Availability  Communication  Good Patient Relations  Positive Track Record on Referrals  Participates in Preferred-Provider Network

7.  Assesses the medical aspects of the illness, injury or trauma that gave rise to the claim;  Corresponds with treating physicians and arranges for referrals to specialists as needed;  Ensures that physicians keep employers, workers’ compensation insurers apprised of recommendations, including returning to work and any restrictions on employment;  Evaluates and monitors the individual’s progress in rehabilitation and specialized rehabilitation;  Recommends the appropriateness and the types of post- acute care to achieve the best possible outcome for the individual by the most cost-efficient means.

8.  Better Care for Injured Worker  Reduction in Medical Costs  Reduction in Claims Duration  Reduction in Indemnity (Lost Wage Benefits)  Reduction in Pharmaceutical Costs