Case, Medical Care & Return-to-Work Management

Workplace injuries impact the businesses of any organization, irrespective of their size, in terms of reduced productivity and increased workers’ compensation claims. While the prolonged absenteeism of injured workers disrupts the revenues of employers, it will lower the self-esteem of injured workers. Thus, a Return-To-Work (RTW) program can put both the employers and the workers in a win-win situation by reintegrating the injured workers into the workplace as soon as they are medically able.

And, for a successful return-to-work management, organizations must adopt a right structure, plan, and execution with a proven case management system. While the workers’ comp industry is flooded with multiple case management software solutions, employers need a one-size-fit-for-all solution, which can connect workers, employers, providers and payors on a single platform.

To streamline Return-To-Work (RTW) processes, Xybion Emidence Case Management Solution allows integration with multiple stakeholders and supports case managers in multiple phases of case management; from capturing incident report to the closure of a claim by capturing Bio-Psycho-Social information.

While the fully digital platform of Xybion helps accelerate the return-to-work processes, it supports the workers with an improved injury claim management system.

Xybion’s incident and case management platform provides you with the tools to manage and track incidents and cases in a cost-efficient way promoting full recovery and return-to-work objectives. Integrated with internal and external systems, our platform provides you with current evidence-based guidelines required nationally and statewide to promote recovery and reduce costs.

  • Integrated digital platform internally and externally Configurable for your business, Guided questionnaires to capture relevant details
  • Report and manage incidents by category, Seamlessly transfer data to OSHA forms
  • Manage workflows between HR and supervisors,  Coordinate care between providers
  • Manage Return-to-Work Functions
  • Perform and manage assessments of occupational hazards
  • Generate site specific reports or aggregate them across the organization

Xybion’s Case Management Module Features

The complete functionality of case management depends on the authenticity of communication received from patient’s clinic visit and on the accuracy of incident management reports. Xybion’s Workers’ Comp Cloud™ for employers integrates with their respective HR Databases to collect the incident/injury details, such as the location of the injury, witness available and the cause and environmental factors.

Here, Xybion’s digital platform allows case managers to access the data in real-time to create the first-action-post-incident report using Bio-Psycho-Social information of employees. This report will also help Payors analyze the validity of the claim.

Automated Rules Engine for Case Assignment and Routing

Using multiple modules of Emidence-XD, the automated rules engine helps streamline the case management workflows, such as incident reporting, patient-intake during the clinic visit, diagnosis reports and injury claim reports.

Additionally, by capturing the bio-psycho-social information of an injured employee, Xybion’s digital platform mitigates the workload of case managers, where the information is used to consolidate, track, verify, and generate return-to-work reports in adherence to State and Federal rules.

Reduce Medical Costs via Evidence-Based Care Path

Xybion’s evidence-based care platform improves efficiencies, accuracies and controls of a workers’ comp system by integrating disparate systems, such as claim management, absent/leave management and care management systems through configurable workflows.

The case managers can analyze the injured employee’s fitness level by comparing incident reports and the diagnosis report of providers. Further, the report can be discussed with the employee and the providers. This process can help the employee in early return-to-work.

Real-time Access to Prior Authorizations (RFA)

Xybion’s digital platform for Case Management provides a complete digital process for prior authorization between the provider and the payor, where the system generates compliant Requests for prior Authorization (RFA) in line with various State guidelines. Additionally, Xybion captures evidence-based (ACOEM, MTUS and other State Guidelines) information.

Electronic Case Notes

The automated workflows allow case managers to avoid tedious data entries by capturing all the reports in electronic format with secured e-signatures. In addition, the case managers can reduce data errors by auto-populating patient and providers’ electronic data by integrating claim management system with patient portal of Xybion.

Other features

  • Provider assignment
  • Improve return to work outcomes
  • 100% web-based, SaaS platform, mobile friendly
  • Improves workforce productivity
  • Reduces claim costs with reduced absent work days
  • Reduces disability claims
  • Mitigates work performance issues