Improving outcomes.
Changing lives.
We’re in this together.
Boutique-quality Case Management, UR and Field Investigation/Outside Adjuster services focused on facilitating a rapid progression of claims to closure through education, advocacy, out-of-the-box thinking, and a proactive approach to challenges.
Areas of Practice
Nurse Triage
24/7 Nurse Triage line manned by workers’ comp case managers who understand the importance of both expeditious treatment as well as the appropriate level of care. Employers who provide a 24/7 Nurse Triage service to employees can often see a reduction in claims of up to 40% as many calls require only a “self-care” recommendation with no additional treatment ever needed.
Nurse Case Management
Nurses are continually ranked the most trusted profession in the country and have been for over the last 20 years. Our trusted, licensed professionals are not only knowledgeable nurses, but they are well-trained in state specific work comp statutes and guidelines. Through a proactive approach to claims management, they ensure employees are treated appropriately, effectively, and efficiently. Customized care plans, with a team approach prevent interruptions to the progression of recovery to MMI, unnecessary treatment, and litigation.
Field Investigation
Initial investigation of claims. Licensed Outside Adjusters meet with injured employees and employers to secure a recorded statement, initial claim documents, and any documentation provided by the employee, as well as provide education on the WC process. OAs also meet with employers to secure any video records, witness statements, relevant payroll reports, as well as photograph the accident scene when needed.
Utilization Review
Review of request for medical necessity based on Louisiana’s Medical Treatment Guidelines. Physician Reviews are completed by physicians who are not only licensed in Louisiana, but also practice in the state. Peer-to-Peers are scheduled with the requesting provider whenever possible to prevent wasted time and the need for multiple requests. UR and Case Management are connected to reduce denials based on missing documentation or approvals on non-compensable injuries/body parts—a true team approach to care.
Bill Review and Negotiation
Louisiana spent nearly one billion dollars in 2019 on medical costs associated with workers' compensation claims. Carriers and employers are overly burdened with inappropriate billing, outpatient charges, physician dispensed medications, and claims for unauthorized treatment. Our team can help. Our bill review and negotiation services are fully customizable and billed at flat fee, not based on any “percentage of savings.”
Resource Management
Our team works diligently behind the scenes to ensure the system works for you. From contract negotiation with providers, to assisting employers with implementing state specific resources, Integrix is there to help control costs while still providing excellent care to your injured employees.
Get in Touch
Our experienced and knowledgeable team of nurses and claims handlers are working hard to improve our industry, one claim at a time. We’re focused on expediting positive outcomes and doing it the right way.