Cat Care Program
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S&H Medical S&H Medical Management Services, Management Services, Inc. Inc. CAT Care™ CAT Care™
description
This power point details the elements of the S&H Catastrophic Case Management Program
Transcript of Cat Care Program
S&H Medical Management S&H Medical Management Services, Inc. Services, Inc.
CAT Care™CAT Care™
CAT Care Program CAT Care Program S&H Medical Management S&H Medical Management
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S&H CAT Care™S&H CAT Care™
Catastrophic injuries or illnesses Catastrophic injuries or illnesses can strike at any time. can strike at any time.
S&H Medical Management S&H Medical Management Services, Inc. is your source for Services, Inc. is your source for goal-directed, timely and cost-goal-directed, timely and cost-effective catastrophic case effective catastrophic case management services.management services.
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S&H CAT Care™ - Initial ContactsS&H CAT Care™ - Initial Contacts
Many times the initial contact Many times the initial contact with the family made by the with the family made by the S&H CAT Nurse is the first S&H CAT Nurse is the first contact the family will have contact the family will have with an employer or adjuster with an employer or adjuster representative.representative.
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S&H CAT Care™ Connection to S&H CAT Care™ Connection to Real Time Information Real Time Information
At a time when information is scarce At a time when information is scarce and the family, the employer and the and the family, the employer and the adjuster require a connection to real-adjuster require a connection to real-time information, the S&H CAT Nurse time information, the S&H CAT Nurse is there to facilitate the needed is there to facilitate the needed communication, assess if treatment communication, assess if treatment is timely, aggressive and is being is timely, aggressive and is being provided at an appropriate facility! provided at an appropriate facility!
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Initial Goals of S&H CAT Care™Initial Goals of S&H CAT Care™
The S&H goal for RN catastrophic The S&H goal for RN catastrophic case management is to provide an case management is to provide an immediate, mutually beneficial (to immediate, mutually beneficial (to both the injured worker/recipient and both the injured worker/recipient and the claims handler) response, the claims handler) response, ensuring facilitation of the medical ensuring facilitation of the medical care required to return this injured care required to return this injured worker/recipient to a productive life.worker/recipient to a productive life.
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Initial Goals of S&H CAT Care™Initial Goals of S&H CAT Care™
The nurse works closely with all The nurse works closely with all parties to ensure communication parties to ensure communication and appropriate care during the and appropriate care during the first critical hours and days first critical hours and days following a catastrophic injury following a catastrophic injury coordinating if necessary, a coordinating if necessary, a transfer of treatment to a Center transfer of treatment to a Center of Excellence.of Excellence.
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Ultimate Goal of S&H CAT Care™Ultimate Goal of S&H CAT Care™
The S&H CAT Nurse is there The S&H CAT Nurse is there to keep all parties focused on to keep all parties focused on the goal of a safe and timely the goal of a safe and timely return to work and/or return to work and/or appropriate utilization of appropriate utilization of resourcesresources
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Criteria for Referral for CAT CareCriteria for Referral for CAT Care Severe burnsSevere burns Spinal cord injury/paralysisSpinal cord injury/paralysis Traumatic Brain InjuryTraumatic Brain Injury Coma, stuporComa, stupor Multiple trauma/crushing injuriesMultiple trauma/crushing injuries Organ failureOrgan failure Chemical/radiation exposureChemical/radiation exposure AmputationAmputation Claiming mental stress/psychiatric Claiming mental stress/psychiatric
condition as a result of the injurycondition as a result of the injury
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Delivery of S&H CAT Care™Delivery of S&H CAT Care™
The S&H CAT Care product is The S&H CAT Care product is delivered by full-time, regular S&H delivered by full-time, regular S&H employees, the same nurses that employees, the same nurses that work with our accounts on a daily work with our accounts on a daily basis. Check with your national basis. Check with your national catastrophic case management catastrophic case management providers to determine if they utilize providers to determine if they utilize outside contractors to provide this outside contractors to provide this service. service.
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S&H Medical Management CAT S&H Medical Management CAT Care is always on call!Care is always on call!
S&H is available S&H is available 24 hours/day - 7 days/week by calling 24 hours/day - 7 days/week by calling 630-226-5036630-226-5036 when catastrophic case when catastrophic case management is required.management is required.
S&H utilizes an after-hours call service S&H utilizes an after-hours call service utilized by Level 1 Trauma and utilized by Level 1 Trauma and Transplant teams, to ensure your after-Transplant teams, to ensure your after-hour call is handled appropriately and hour call is handled appropriately and in an expedited manner.in an expedited manner.
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S&H Medical Management CAT S&H Medical Management CAT Care is always on call!Care is always on call!
The S&H Management Team is alerted The S&H Management Team is alerted upon referral, and makes the initial upon referral, and makes the initial calls to the facility in question to obtain calls to the facility in question to obtain current acuity and admission current acuity and admission information. information.
Based on this call and adjuster request, Based on this call and adjuster request, a decision is then made as to whether a decision is then made as to whether the CAT Nurse will need to make an the CAT Nurse will need to make an immediate on-site visit, versus immediate on-site visit, versus deferring activity until the next deferring activity until the next business day.business day.
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S&H CAT Care™ RN QualificationsS&H CAT Care™ RN Qualifications
S&H CAT Care is performed by registered S&H CAT Care is performed by registered nurses experienced in managing trauma, nurses experienced in managing trauma, orthopedic or neurological injuries. orthopedic or neurological injuries.
Licensure as a Registered Nurse; Licensure as a Registered Nurse; preferably with a degree in nursing (BSN) preferably with a degree in nursing (BSN) from an accredited school. from an accredited school.
A minimum of 2 years related clinical A minimum of 2 years related clinical and/or medical case management and/or medical case management experience with a focus on experience with a focus on catastrophically ill or injured individualscatastrophically ill or injured individuals
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S&H CAT Care™ RN QualificationsS&H CAT Care™ RN Qualifications CCM certification or scheduled to sit CCM certification or scheduled to sit
for the examination for the examination Maintenance of continuing education, Maintenance of continuing education,
minimum of eight hours annually, minimum of eight hours annually, specific to catastrophically ill or specific to catastrophically ill or injured individualsinjured individuals
Demonstrates accountability and Demonstrates accountability and skills in analysis, decision making skills in analysis, decision making and proficient in verbal and written and proficient in verbal and written communicationcommunication
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Training for S&H CAT Care™Training for S&H CAT Care™
The S&H CAT nurse receives internal The S&H CAT nurse receives internal specialized training.specialized training.
Quality Assurance of CAT Care Quality Assurance of CAT Care services is provided by the RN’s services is provided by the RN’s Manager that helped design and Manager that helped design and implement the S&H CAT Care implement the S&H CAT Care program. program.
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Resources provided for the Resources provided for the S&H CAT Care RNS&H CAT Care RN
A workbook and S&H Intranet A workbook and S&H Intranet resources detailing: resources detailing:
Certified Trauma Centers nationwide Certified Trauma Centers nationwide Certified Rehabilitation Centers / Certified Rehabilitation Centers /
Facilities NationwideFacilities Nationwide Spinal Cord and Brain Injury Centers Spinal Cord and Brain Injury Centers
Acute and Long - TermAcute and Long - Term Transportation, National DME, and Transportation, National DME, and
Education resources Education resources
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S&H CAT Care™ Partners with S&H CAT Care™ Partners with PRN Review NetworkPRN Review Network
However, there are times when However, there are times when coordinating the catastrophic care of coordinating the catastrophic care of an individual, a Nurse Consultant will an individual, a Nurse Consultant will require the input of an objective, require the input of an objective, unbiased physician trained in the unbiased physician trained in the appropriate Trauma discipline, to appropriate Trauma discipline, to consult with regarding the consult with regarding the appropriateness of care proposed by appropriateness of care proposed by the treating physician. the treating physician.
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S&H CAT Care™ Partners with S&H CAT Care™ Partners with PRN Review NetworkPRN Review Network
S&H Medical Management S&H Medical Management Services, Inc.Services, Inc. is pleased to is pleased to announce we have teamed up with announce we have teamed up with Physicians’ Review NetworkPhysicians’ Review Network to to round out the S&H CAT Care round out the S&H CAT Care program! program!
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S&H CAT Care™ Partners with S&H CAT Care™ Partners with PRN Review NetworkPRN Review Network
Physicians' Review Network (PRN) is Physicians' Review Network (PRN) is a URAC accredited, Independent a URAC accredited, Independent Medical Review Organization. Medical Review Organization.
PRN’s review process ensures that PRN’s review process ensures that physicians in the required specialty physicians in the required specialty are involved in decisions regarding are involved in decisions regarding the medical necessity of requested the medical necessity of requested healthcare services. healthcare services.
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S&H CAT Care™ Partners with S&H CAT Care™ Partners with PRN Review NetworkPRN Review Network
Since PRN performs these medical Since PRN performs these medical reviews outside of the client's reviews outside of the client's operations, there is no pressure on operations, there is no pressure on PRN to make medical PRN to make medical determinations in favor of one determinations in favor of one party over another. The PRN party over another. The PRN physicians are independent and physicians are independent and neutral.neutral.
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S&H CAT Care™ ReportingS&H CAT Care™ Reporting
A CAT Care Quick Report™ is emailed to A CAT Care Quick Report™ is emailed to the adjuster within 24 hours of the CAT the adjuster within 24 hours of the CAT Care Nurse’s initial onsite visit. This report Care Nurse’s initial onsite visit. This report is designed to be a “snapshot” of the is designed to be a “snapshot” of the claimant’ current condition. claimant’ current condition.
The adjuster will receive weekly Quick The adjuster will receive weekly Quick Reports for the first 30 daysReports for the first 30 days
Typically the second 30 days should Typically the second 30 days should require bi-weekly Quick Reports, with require bi-weekly Quick Reports, with discussion of decreasing to a 30 day discussion of decreasing to a 30 day reporting timeframe following this period.reporting timeframe following this period.
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S&H CAT Care™ ReportingS&H CAT Care™ Reporting A comprehensive CAT Report will be A comprehensive CAT Report will be
completed at the point the patient is completed at the point the patient is able to respond to questions, or the able to respond to questions, or the pertinent information can be gathered pertinent information can be gathered from family members. This report is from family members. This report is to be dictated within 48 hours of the to be dictated within 48 hours of the information being gathered, and the information being gathered, and the report is then expedited by the RN report is then expedited by the RN Manager, to be delivered to the Manager, to be delivered to the carrier, TPA or self-insured employer.carrier, TPA or self-insured employer.
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S&H CAT Care™ S&H CAT Care™ USA and Beyond!USA and Beyond!
The S&H CAT Care Program was The S&H CAT Care Program was instituted in February 2007!instituted in February 2007!
This program can also be utilized This program can also be utilized for international catastrophic for international catastrophic injuries or medical conditions!injuries or medical conditions!
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S&H CAT Care™ PricingS&H CAT Care™ Pricing
Pricing for the S&H CAT Care Program, Pricing for the S&H CAT Care Program, including after hours dispatch to a facility, including after hours dispatch to a facility, will be addressed upon request.will be addressed upon request.
We believe you will find the S&H CAT Care We believe you will find the S&H CAT Care Program is intensive, comprehensive, Program is intensive, comprehensive, combines the proper mix of Case combines the proper mix of Case Management and Physician review, while Management and Physician review, while providing a very cost-effective and providing a very cost-effective and competitive product. competitive product.
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S&H CAT Care™S&H CAT Care™ Let S&H be your regional Let S&H be your regional
provider of CAT Care in the provider of CAT Care in the Midwest!Midwest!
24/7 Point of Contact: 630-24/7 Point of Contact: 630-226-5036 226-5036
Thank you for considering Thank you for considering S&H!S&H!
