Program Design
How to Use Evidence Based Medicine to Create Better Workers’ Comp Claim Outcomes
How to put medical evidence behind every claim decision
Playbook content
Introduction
- PDFPlaybook outlineDownload · PDF
- Evidence-Based Medicine Helps Us Make Better DecisionsVideo · 4:18
Section 1
- Hierarchy of EvidenceVideo · 20:20
- Protocol check 1Pass at 70%
Section 2
- EBM Results & 3 Goals of Duration GuidelinesVideo · 17:48
- Protocol check 2Pass at 70%
Section 3
- Claim Examples Using EBMVideo · 18:00
- Protocol check 3Pass at 70%
About this playbook
Workers' comp claims are medical injuries, and an adjuster's workload leaves little room for accurate medical determinations. This playbook covers the hierarchy of evidence, the three goals of duration guidelines, and how to use evidence based medicine, doctor questions and IME questions to get appropriate treatment approved and move claims toward resolution.
You will be able to
- Integrate evidence based medicine tools into your claims process
- Avoid excessive treatment and costly compound prescriptions
- Get appropriate treatment approved
- Use doctor and IME questions to move claims toward resolution
- Recognize inappropriate use of utilization review