Downers Grove, IL – Comprehensive benchmarks and enhanced risk scoring are among the enhancements to Coventry’s claim-management tool, Coventry Connect to more readily identify injured workers who could benefit from heightened oversight.
The improvements to the Coventry Claim Profile, a decision-support tool for claim and clinical professionals, underscore the role of Coventry Connect® as the essential engine for managing all aspects of a claim from injury to closure.
The enhanced Claim Profile incorporates Work Loss Data Institute’s Official Disability Guideline (ODG) benchmarks and risk-acuity scoring for claims. Adding the ODG signposts to the claim profile deepens the well of available data currently displayed through the Coventry Connect portal to help claim professionals and case managers recognize emerging risk and intervene immediately. Coventry’s rich data store, now coupled with ODG scoring, allows for detailed analysis of claim attributes such as high-risk pharmacy utilization patterns and any comorbidity data to render a risk-acuity score.
This information acts like a heat map for defining future claim strategy. The score pinpoints the greatest risks overhanging an injured worker’s recovery.
The next-generation Claim Profile assists claim professionals in estimating appropriate reserves and identifying injured workers who could most benefit from additional oversight. The rules engine and end-to-end data repository within Coventry Connect make it the most powerful tool available for collecting and acting upon all information related to a claim.
The science-based analyses that arise from Coventry’s integrated benchmarks and risk scoring also prompt Coventry nurses to provide health coaching that is tailored to a worker’s compensable injury as well as any complicating comorbid conditions. Engagement in a personal health-coaching relationship enables injured workers to become active partners in their own recovery and return to productive function.
“We’ve created an evidence-based tool to provide our clients and case managers medical and indemnity benchmarks and a risk-assessment score,” says Anne Levins, vice president product development. “We are delivering greater depth and breadth of information to aid claim professionals in goal-setting, calculating savings and in making assignments to clinical interventions. We believe these enhancements will improve claim management efficiency and overall outcomes for our clients and their injured workers.”
For more information on Coventry Connect and to download Coventry Connect mobile please visit www.coventrywcs.com.
Source: Coventry
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