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Medical Cost Containment

Medical Cost Containment
 

Medical Cost Containment Approach

All cost savings are passed along to all of our clients. There are no hidden costs that benefit IPMG.

Medical cost savings practices include:

Provider Network Discounts and Bill Review Network

Our bill review network partners achieve a solid PPO penetration rate. Since the implementation of the Illinois Fee Schedule, our partner bill reduction over the past few years has been close to 40%. Inclusive of bill review charges, the net cost savings currently averages in the range of 35%.

Preferred Provider Program

IPMG offers employer groups an approved Preferred Provider Program (PPP) option.  Sections 8(a) and 8.1(a) of the Act authorize employers to create Preferred Provider Program (PPP) for workers' compensation medical care.

Promote Transitional Duty Return to Work Programs with a Proactive Multi-Specialty Team Approach

IPMG has an internal team comprised of claims management, nurse case management, and risk management.  Our goal is an early and safe return to work with the focus on the injured employees’ abilities. Our specialty team is proficient at finding creative ways to return injured employees back to work, which results in substantial cost savings for the clients.

Pharmacy Program - Prescription Card Service

IPMG has pharmacy management partners who carry well over 50,000 pharmacies in the U.S.; in Illinois alone, they carry well over 3,000 pharmacies.

Our program service consists of the issuance of a benefit ticket, as well as an acknowledgment letter, to the injured employee within 24 hours.

Our pharmacy program partners boast an average savings of 22% below usual and customary charges in Illinois. They also provide a web portal for adjuster access, allowing pain management adjustments to take place within 6 seconds. This allows for our adjuster to implement any necessary authority restrictions on any patient.

Case Management Program

IPMG has an in-house medical case management team that offers several services that are able to be customized to meet the specific needs of the client.

Medical case management is offered throughout the lifecycle of the claim. Case management may be assigned at the early intervention phase or may be established at any time during the claim duration. 

IPMG’s Case Management Program incorporates industry standards and utilizes multiple evidenced-based medicine guidelines in their daily practice of case management. During the triage process the cases are evaluated for injury severity, disability, and any co-morbidity to determine the need and appropriate level of assignment for case management services.

IPMG’s case management program offers:

  • Triage
  • Full Case Management Services
  • Task-Based Assignments
  • Disability Case Management
  • Psychiatric Case Management
  • Independent Medical Evaluations
    Scheduling and Coordination
  • Medical File Reviews
  • Causal Relatedness Resource
  • Medical Bill Review Assistance
  • Treatment Projections
  • Consultation and Resource

Direct supervision with ongoing quality improvement activities is an integral component of the IPMG’s Case Management Program.

Utilization Management

IPMG partners with select vendors to provide utilization management services specific to the regulatory and clients’ requirements. IPMG offers partners that are URAC compliant Utilization Management programs that are designed to positively impact claims costs and provide savings to the claim.

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