The new Prosthetics Clinical Review Program, developed by One Call Care Management Inc, aims to provide additional oversight in the prosthesis-selection process for both patients and payors.
Via the program, an American Board for Certification (ABC) Certified Prosthetist (CP) provides insights to help patients and claims adjustors understand the complexities of prosthetics and make informed decisions regarding the best prosthetic device for the patients’ needs.
“As artificial limb technology advances, the complexity in managing claims for injured workers who have suffered from limb loss increases,” says Zack Craft, vice president and national product leader at Jacksonville, Fla-based One Call Care Management, in a media release.
“The Prosthetics Clinical Review Program addresses this need to achieve better outcomes for the injured worker and savings for the workers’ compensation payor.”
According to the release, prosthetic referrals meeting the following criteria will typically trigger the assistance of the Prosthetics Clinical Review Team: Myoelectric Upper Extremity Systems; System Upgrades and/or Excessive Replacements; Microprocessor Controlled Knee and Ankle Prosthetics; and Excessive Socket Changes.
Depending on the complexity of the case, assessments are typically completed in less than 4 business days. Savings for workers’ compensation payors will vary depending on the outcome of each assessment; however, recent case studies have shown savings of up to 52%, the release adds.
[Source(s): One Call Care Management, Business Wire]