Sedgwick Case Management

Improved Essays
In Addition to the above, the claim teams are supported by several resource units within the Sedgwick claims operation; nurse case manager, subrogation and fraud units. All three units are designed to off load some of the technical claim staff’s responsibilities while impacting claim cost.

Sedgwick reported the following savings and or recovery from their three resource units for the 2014 and 2015 calendar years. Nurse Case Manager saving’s for 2014 was $128,445 and $956,789 for 2015. Sedgwick advised these savings are derived from their Nurse Case Manager’s early intervention with medical management while also having a partial impact on the injured worker’s return to work through alternative work assignments.

Other resource units impacting

Related Documents

  • Improved Essays

    Nt1330 Unit 3 Paper

    • 596 Words
    • 3 Pages

    Question 1 The unit clerk is not considered part of the variable staff because his or her salary remains the same regardless of the increase in the level of activity. A unit clerk is responsible for some duties that relate to organizing and making updates of information about the nursing units, coordinating the work of the unit and also with other departments and units. Thus, regardless of the amount of work they do on holidays and vacations, their pay stays constant and does not raise or reduce. Question 2…

    • 596 Words
    • 3 Pages
    Improved Essays
  • Decent Essays

    Com 453 Week 3 Assignment

    • 673 Words
    • 3 Pages

    Shari Mooney COM 453 (Fall 2015 – Session B) Assignment One (A1): Description of Organization Part 1: Organizational Information 1. Name of the organization and the specific business or service(s) they provide Name: Prescott Radiologists, LLP. Service(s) Provided: Medical billing and coding. 2. History of background Prescott Radiologists was started in 1971 by a group of radiologists.…

    • 673 Words
    • 3 Pages
    Decent Essays
  • Decent Essays

    I’ve had the opportunity of completing my clinical rotation at Baptist Hospital with the medical team in which I've observed the different participants in the collaborative team and the specific role each person played. The team consists of physicians, surgeons, social worker, ARNP, physical therapist, and occupational therapist. While observing the team, the best outcome for the patient's treatment and prognosis is focused on before being discharged. For example, if the patient does not have insurance coverage, community resources are addressed to assist and provide the patient with the proper care post discharge. Learning how cares for patients that have been newly diagnosed with various neurological diseases as well as their long-term care…

    • 196 Words
    • 1 Pages
    Decent Essays
  • Superior Essays

    1520 Sedgwick Case Summary

    • 1070 Words
    • 4 Pages

    The legal process of gentrification is potentially one of the more easily argued cases, especially in a country that prides itself on its free market. Using 1520 Sedgwick as an example as well I will compare how the ideals of a free market economy would effect it with the realities of the situation. First of all, if the US was a true free market economy 1520 Sedgwick would never have been enrolled in the Mitchell-Lama program because such a system wouldn’t exist unless the government owned the property, which also would be contrary to a free market system. Following the fact that these programs do exist and the government does play a role in the economy, including real estate, we have to conclude that the government has to assume at least some sense of responsibility for the citizens enrolled in the Mitchell-Lama program. However, this does not just include the residents of 1520 Sedgwick, but the owners as well, for the government entered into an agreement with them as well.…

    • 1070 Words
    • 4 Pages
    Superior Essays
  • Improved Essays

    Fiscal Concerns in the Health Care Setting Case Study As a manager of a unit, certain responsibilities and obligations are difficult to manage. There are major tasks that are connected, and each flows in a different direction, and the responsibility always lies with the manager. In a healthcare setting, the importance of nurses in contributing to fiscal planning has been recognized. According to Marquis and Huston (2012), nursing managers have to be experts in financial matters to ensure that there are patient and staff satisfaction within their organization. Therefore, to ensure that resources are used wisely and timely in a cost effective manner, nurse managers are supposed to have an appropriate balance when spending allocated finances and…

    • 1091 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    To assume responsibility for all aspects in the running of the home in its entirety and ensure that every service user has an allocated key worker. Be responsible for one or more allocated service users and take the lead in all aspects of the care and support of the service user To assume responsibility for the monitoring of every service user in the home and ensure that any mental or physical health progress is communicated, documented and followed up where appropriate To ensure person centred care plans and risk assessments are drafted and reviewed regularly within the home. To ensure regular reports and daily progress notes are completed accurately and made available when required by staff. To oversee that all staff convey weekly 1:1 review meetings with allocated service user.…

    • 621 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Case Study: Gentiva

    • 1874 Words
    • 8 Pages

    Gentiva has several branches located in Greenville, Anderson, Pickens and other area. Gentiva is a home health agency and a hospice agency. Gentiva is currently part of the Kindred company. This is a great resource for gentiva clients because they can be transferred to the care they need based on their health. If the client is recommended for hospice but their health changes their health records can be transferred to home health.…

    • 1874 Words
    • 8 Pages
    Improved Essays
  • Improved Essays

    But one of the nurse in recovery unit refused to help her and said that S.D’s husband can help her with the task. On further inquiry, S.D. reports that nurses in recovery unit worked 12 hour shifts compared to the 8 hour shifts that nurses in Labor unit worked. And long work hours increase the risk for reduced job performance, obesity, injuries, and fatigue-related errors could harm patients (Caruso & Claire, 2014, p.19). Fatigued nurses also endanger others during their commute to and from work (Caruso & Claire, 2014,…

    • 527 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    The Case of Lonnie and Dorothy 1. List the needs that Lonnie and Dorothy have. Then prioritize them. The needs that Lonnie and Dorothy have are important to be met in order for them to live comfortably.…

    • 905 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Referrals are one of the biggest things we do. We are constantly making referrals. We make a lot of referrals because most people come to the hospital when they are very sick, have an addiction, or a mental illness. Once they are treated and no longer need medical attention, they are referred out of the hospital and into the community. For example, most elderly patients who are 65 and older, often get referred to sub-acute rehab, skilled nursing facilities, home care, Adult Protective Services, hospice care, or palliative care.…

    • 641 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Referrals Service users can access care services in numerous ways. Every type of care services has a referral system .There are three different of methods of referrals in health and social care: Self-referral, Third-party referral and Professional referral. Self-referral: Self-referral is when a person applies for a care service by themselves. This includes making an appointment to see you GP (family doctor), calling NHS Direct for information or advice or going to visit the opticians for an eye-test.…

    • 1424 Words
    • 6 Pages
    Improved Essays
  • Superior Essays

    “Every single day you learn something new,” Nurse Medina says, “ and if you look at everything there is usually never a double moment.” Medina works in the Emergency Room (ER) at Lenox Hill Hospital where she experiences different situations that occur in the department. Nursing isn’t as simple as it sounds. Working twelve-hour shifts with different scenarios every day is arduous for the nurse practitioner that manages the ER. Working in the ER to save a life may sound a bit cliche, “But when you can really save a life that is worth saving what I mean of worth saving is that the person will have a good outcome.…

    • 1670 Words
    • 7 Pages
    Superior Essays
  • Improved Essays

    The AACN suggests nurses nurse staffing must ensure an effective match between nurse skills and patient needs (AACN, 2016). Not only does inappropriate staffing lead to medical errors, it can also bring about stressed and overworked nurses. The unit I work on is often short-staffed leading nurses to take on more than they are used to and leaving charge nurses scrambling to assign duties and calling in reinforcements. To the best of my ability, I will try to match my nurse’s abilities to the patient’s acuities and request critique if the assignments do not work effectively with current staffing. In order to address the staffing needs and the workflow that changes hour to hour, I believe the implementation of a resource nurse role will help address the staffing needs when patient loads become hectic.…

    • 1013 Words
    • 4 Pages
    Improved Essays
  • Great Essays

    Speaking clearly and calmly, not making a big deal about it. If the individual way ill it would be up to the staff to attend the individual’s hygiene needs and assess what needs they have. The staff need to take into account the individuals preferences and culture. In this situation I must ensure I do not put my personal experiences on the individual and respect their decisions on how they wish to be cared for. 2:2 Describe how to make an individual aware of the effects of poor personal hygiene I would look at the individual’s health and see if there was any reason other than poor hygiene that may explain things.…

    • 1683 Words
    • 7 Pages
    Great Essays
  • Improved Essays

    In 1998, a nursing shortage began due to the confluence of several factors that were, at the time, unknown. The lack of nurses is becoming apparent and putting out negative effects for the world to see through the registered nurses habits in caring for these patients. Hospital administrators suggested higher wages and increased training for nurses; however, efforts to provide these did not end the shortage. The controversy here is higher wages cannot make up for being intensely overworked, causing severe exhaustion and job dissatisfaction…but some people are still trying to increase wages without reducing workload. Because many aspects of society are affected, the nursing shortage has become a concern among hospital administrators.…

    • 1446 Words
    • 6 Pages
    Improved Essays