Total Case Management is used, which is an ‘end to end process’ involving tracking absences, conducting thorough and in-depth interviews, handling short term disability claims and coordinating long term disability claims.
There are three steps in the CareCoach® Ability Case Management process:
1. Early Intervention:
With early intervention, employees who are absent from work will be contacted by a CareCoach®. The CareCoach® will assess their situation, determine if a long term disability experience may occur, and recommend a course of action, if necessary.
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Once this initial contact is made, employees in need of early intervention resources are provided with:
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Medical referrals
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Funding for treatment, equipment or other programs
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Other assistance necessary to help them to return to work as quickly as possible
The focus of this service is to prevent a long term disability experience, where possible, and to alleviate hardship for employees and their families and ultimately return the employee back to productive employment.
2. Claims Adjudication
Claims adjudication is a broad based, end to end process that involves administering short term and long term disability insurance claims as well as work related disabilities covered under the provincial Workers Compensation Board plans.
Outsourcing the administration of these plans allows Sykes CareCoaches® to effectively manage these claims and allows the employer to focus on their core competencies. A successful claims adjudication process ensures that the employer and the employee are actively partnering with the CareCoaches® and are continuously in the communication loop.
3. Successful Return to Work Coordination:
A key service within CareCoach® Ability Case Management is the return to work process, where returning the disabled employee back to work quickly and effectively is a win/win outcome for all parties.
As an unbiased third party, Sykes CareCoaches® will also provide maintenance or follow up protocols after an employee has returned to work full time in order to ensure that there is sustainability, and if necessary, will provide immediate assistance and support if needed.
CareCoaches® also will identify potential barriers in returning to work, address the root cause and provide resolution. The specific CareCoach® who is responsible for an individuals return to work works closely with the employee to identify potential barriers in the process. Together, and with employer input, it is determined how to eliminate or diminish these potential barriers through the development and implementation of a return to work plan.
The CareCoach® Difference:
What’s different about Sykes or the program that I can’t get from another organization?
1. Early intervention will ensure that the initial interview with the employee will take place within 3 days, with a decision of either ‘pending’ or ‘active’. This action will ‘speed up’ the process, and further decrease the chances of the employee proceeding into a short term disability scenario providing the employer with more productive employees, faster ‘return to work’ times and saving future benefit cost dollars.
2. Proactive ‘as it happens’ reporting to corporate client to communicate who we will not be case managing, and why. This will give the corporate client the opportunity to ‘intervene’ based on knowledge they have about that employee, which would lead the Care Coach to proceed with Case Management. Faster information and decision making will enable the employer to make better decisions, providing the employer with more productive employees, faster ‘return to work’ times and saving future benefit cost dollars.
3. Post return to work communication with the employee will continue for four weeks after returning to work full time, as this is a critical period where the employee’s chances of a ‘re-lapse’ are greatest. Less re-lapses obviously mean providing the employer with more productive employees, and saving future benefit cost dollars.
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