Sedgwick is committed to helping clients maximize the value of their employee care programs. We believe that clients are looking for continuing advancements from their workers’ compensation and managed care providers. They want provider networks focused on improved outcomes and not just cost and delivery of quality care not just managed care. They are also looking for more transparency from their business partners.
Our workers’ compensation managed care differs from other companies because it begins with a healthcare model built on the following four guiding principles, which are fully integrated into the claims administration process:
1. Deliver quality, timely care to the injured worker;
2. Streamline the care delivery model;
3. Drive desktop efficiencies for our colleagues;
4. Ensure positive impact to cost of risk.
Sedgwick provides employers with an integrated approach including comprehensive managed care and claims services customized to meet each employee's individual goals. From the instant the first call is made, to the time one of our nurses follows up soon after an accident occurs, to the moment our examiner closes the claim, each service we provide is truly connected.
Our outcomes-oriented focus includes claims coordination, identification of quality providers, and use of case management services in a way that is designed to restore and improve the health of injured workers. This proprietary concept empowers everyone including physicians, claims examiners and clients.
The breadth of our solutions means that clients can get every service they need – from benchmarking physician outcomes for quality of service to creating return-to-work programs – all under one roof, delivered with the highest customer service levels in the industry. Our flexible model provides a data-driven, clinically focused method providing customers with options to help them manage key medical costs.
Our services include:
• 24/7 clinical consultation
• Utilization review
• Telephonic and strategic case management
• Return-to-work programs
• Field case management
• Physician advisor/peer review
• Catastrophic care management
• National provider benchmarking
• Medical networks
- Outcomes, quality-based network
- PPO, MCO, MPN and HCN
• Specialty networks