SeaBright Insurance, a subsidiary of SeaBright Holdings, has launched a new program in managed care program called 'BrightCurePDQ', which stands for Physician-Directed Quality.
SeaBright has said that upon notice of loss, it will employ a more medically-oriented claim model using doctors to actively manage the medical aspects of selected lost time claims. It identifies these claims using its predictive modeling techniques.
According to SeaBright, the predictive model identifies, early in the life of a claim, those injured employees that represent the greatest cost potential and most serious return to work challenges.
Starting on day one, SeaBright’s occupational medicine and orthopedic physicians will review, authorize, and direct the medical treatment and requests for pharmaceuticals, such as Class II narcotics, which are significant cost drivers of medical claim costs.
SeaBright’s claim examiners will continue to manage the non-medical aspects of these claims, and will work in partnership with the physicians to drive the claim towards a timely and successful closure.
The program is aimed at offering a medical care to return the injured worker back to work expeditiously and to address the rising medical care costs for workers’ compensation claims.
Marc Miller, senior vice president and chief medical officer for SeaBright Insurance, said: ”BrightCurePDQ represents a quantum leap forward in medical management. With physicians managing medical care for our policyholders’ injured workers, better care will be delivered faster, facilitating an earlier recovery and return to work.
This is a win-win scenario as injured workers get a better medical outcome, and employers get them back to work sooner, preserving productivity and lowering overall claim cost.”
The company expects to expand the BrightCurePDQ program, which is available only in California at this time, in selected jurisdictions nationwide by year-end.