Payor Relations Team Serves Insurer Needs and Patient Goals
For insurers, families, and anyone close to the patient, admitting a brain injured person into rehabilitation requires the utmost in planning and oversight. With that goal in mind, Centre for Neuro Skills formed the Payor Relations Department to collaborate with carriers and serve the needs of their patients.
The department is led by a National Director of Payor Relations who manages Regional Directors based in the locale of CNS’ six clinical facilities in California and Texas. This dedicated team builds relationships with area insurance executives and is attuned to the needs of patients in each region.
Streamlining the Rehabilitation Process
Insurance coverage is a key element of the rehabilitation experience, determining length of stay, treatment goals, and discharge planning. The Payor Relations team interfaces with patient stakeholders (insurers, case managers, attorneys, physicians, families, and therapists) to help each patient and their carrier maximize treatment based on coverage parameters.
Working in concert with insurers, the team facilitates:
- Frequent communication between insurers and CNS staff in admissions, accounting, and clinical/medical departments, once the patient is admitted.
- Inclusion of insurer staff on team calls that update stakeholders on patient progress, medications, physician appointments, and health status.
- Updates on patient Activities of Daily Living (ADLs) and Independent Living Scale (ILS) scores that reflect patient status.
- Sharing of patient data derived from ADLs and the ILS that is tracked throughout rehabilitation, illustrating success or where improvement is needed.
- Updates on CNS clinical efficiencies that optimize rehabilitation and foster durability of outcome.
- 24/7 review of patient progress using CNS’ Web-based, secure patient portal.
Building Relationships with National Carriers
Payor Relations staff also meet with such industry leaders as State Compensation Insurance Fund, Liberty Mutual Insurance, The Travelers, and The Hartford. Their market includes workers’ compensation executives, claims adjusters, and key influencers.
CNS has a far-sighted approach in partnering with insurers, emphasizing lifetime savings associated with a proven clinical model. The role of the Payor Relations team is to ensure that core resources are leveraged to foster patient success and enhance outcome.