The niches are getting smaller…ForeSight Medical has launched Encompass Specialty Surgical Network, a surgical network that aims to manage costs for workers’ compensation payers.
“Ambulatory surgical centers are the safest and most efficient sites of care for most workers’ compensation related surgeries, ” said ForeSight President Brian Bell, in the August 23, 2016 news release “However, legacy networks typically focus on broad-based facility agreements, which inadvertently drive over 70% of injured employees’ surgeries into a less efficient, cost-prohibitive site of care, the hospital.”
As indicated in the news release, “Encompass manages surgery from the initial surgical consultation through discharge, streamlining authorization, reserve-setting, scheduling, patient relations, billing, and payment processing. Encompass utilizes a proprietary scoring system to ensure patients see the highest quality, most responsible providers early in the treatment path to ensure the best outcome. Surgical Care Coordinators schedule the procedure with a top quality surgeon who has privileges at an in-network ambulatory surgical center. These coordinators proactively support all aspects of patient care and customer service. An advanced outcomes reporting platform delivers actionable analytics to medical managers, including comprehensive savings, outcomes and provider performance metrics.”
Brian Bell told OTW, “Most workers’ compensation networks contract with surgeons who are affiliated with hospitals. As a result, surgeries that could take place in ambulatory surgical centers are usually done in the inpatient setting, where risks of infection rates are higher, costs are nearly twice as high and patients tend to be much less satisfied, ” said Brian Bell, president of Encompass Specialty Surgical Network.
“Encompass Specialty Surgical Network is the first specialty surgical management organization in workers’ compensation. We’re focused on managing costs through quality of care and better outcomes, and we direct workers’ compensation patients to orthopedic surgeons and that are affiliated with high quality ambulatory surgical centers.
“We contact the patient, make sure he or she is a good a candidate for the recommended surgery, identify the best surgeon in the area for this procedure, handle all preauthorization and scheduling processes, and manage the billing and payment. We want physicians to concentrate on practicing medicine instead of worrying about accounting and bill collection. In fact, we guarantee that our providers will receive expedited electronic payment for authorized and compensable procedures processed through Encompass.”
“The benefits to orthopedic surgeons are incremental volume, financial guarantees, enhanced reporting capabilities and simplified administration for your workers’ compensation-related surgical procedures.”
