Workers’ Comp Centers of Excellence Treat The MegaClaims
The Workers’ Comp Centers of Excellence may reach beyond just MegaClaims. Let us look at the definition of a center of excellence.
Researching the term uncovered the newness of the term and concept. According to a recent Risk & Insurance article
even the definition of centers of excellence remains not a very well-defined area of medical treatment.
According to Ann Perkins, COO, R&Q Health, there is no one set definition of a center of excellence.
But, “one way to look at them is as a center engaged in research. These centers are making contributions to patient health and health care at large. Typically, they treat a large number of patients with the same injury and the results are published and benchmarked with other similar centers,” she said.
In other words, a center of excellence is a team or facility that provides leadership, best practices, research, support and/or training in a specific area, like addiction, spinal cord injuries, heart-related illnesses and the like.
One of the most recognizable centers of excellence seen the most often in claims is the head injury treatment centers or burn centers. The results from those two types of medical treatment centers rise above just being successful.
According to the R&I article, Centers of Excellence balk at the amount of paperwork involved with Workers’ Comp. Can anyone debate that point? (No!) Workers Comp Centers of Excellence want to treat their patients and not be involved with the denial and approval process involved with what can sometimes be a contentious line of insurance benefit.
The centers of excellence concept hammered out a place in Workers’ Comp over the years. WCRI and the NWCDC Vegas set aside a webinar and upcoming sessions at their annual conferences on this topic. One cannot call this concept a fad. Some of the centers started doing business in the mid-1900’s or earlier.
One could call Workers Comp Centers of Excellence value-based care for the extremely large claims. Could these medical providers also treat only Workers’ Comp claims over $250,000 (or maybe less?).
A few carriers and big-house agencies borrowed the term over the last two years. Their concept centers around claims-handling. No names mentioned here.
If you Google the term, you will notice a sparse amount of articles on CSoE. Remember that acronym. WC Centers of Excellence (for medical treatment) will show up in the news within the next year. I guarantee it.
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