Catastrophic Case Manager Honored in Workers' Comp Category
May 12, 2015 â€“ Wayne, Pa. â€” Chris Burgess, RN, BSN, MBA, CLCP, CCM, a medical/catastrophic case manager at Genex Services, was named a Platinum Award winner in the Workers' Compensation Case Manager category by the 2015 Case In Point Platinum Awards Program. Genex Services is the nation's largest provider of workers' compensation clinical services.
The Case In Point Platinum Awards Program is designed to recognize leaders in case management who are improving the delivery of care in the areas they serve. Processes such as transition of care, disease management, behavioral health and other creative strategies are making a difference as the industry works to improve quality of care, while at the same time lowering healthcare costs, officials said.
Burgess was selected for her care coordination of a 60-year-old linesman electrician who sustained life-threatening injuries following a motor vehicle accident which left him non-responsive after a cardiac event. Given little hope for survival at the time of injury, the injured worker was placed on life support and was implanted with an automated defibrillator. Gradually he started to respond to treatment in ensuing weeks, but had sustained anoxic brain injury from the cardiac event as well as kidney failure. He was discharged home a month after the accident with plans to retire from his job.
Genex offers a highly specialized team of credentialed professionals with expertise in catastrophic injury case management, capable of immediate response to such claims. As the catastrophic case manager on the file, Burgess planned a different outcome. Once the claimant was weaned from the ICU, Burgess arranged inpatient rehabilitation placement at the hospital so the claimant could be more comfortable and closer to his family and home environment.
â€œI gained the trust of the claimant, his wife and family, which enabled a smoother transition to home. I coordinated care with his wife, treating MDs, and insurance carrier for outpatient care, and kept in constant contact regarding care and recovery,â€ said Burgess. â€œThe claimant and wife were resistant to having caregivers in the home, so I educated the wife on how to provide care on her own. The claimant was set up with dialysis in the outpatient setting and I educated the wife and claimant to ensure he remained complaint with the treatment.â€
All the while, Burgess continued to coordinate the worker's cardiology, nephrology, and internal medicine specialties for care, and attended each appointment with the patient, ensuring 100 percent compliance. After encouraging the primary physician to perform a functional capacity evaluation to determine the worker's maximum medical improvement level, the results came back favorable for return to work.
Instead of retirement, the worker was back on the job less than a year after the accident, thanks to Burgess' encouragement and commitment to returning him to his highest level of function.
â€œDespite the claimant's incident, he remained motivated to get better and follow the treatment plan of each provider caring for him,â€ said Burgess. â€œThe cost savings on this case totaled $84,000, and he returned to work in the timeframe identified in [the guidelines].â€
Tim Howard, senior vice president of field case management at Genex, said Burgess' exemplary commitment to her claimant demonstrates the excellent work of Genex's highly skilled and compassionate catastrophic case managers.
"It takes exceptional case managers to manage catastrophic cases, and Genex is proud to have one of the best teams in the business,â€ he said. â€œChris exemplifies the specialized expertise necessary to guide catastrophically injured workers toward optimal recovery and reintegration into society. The Case in Point Platinum Award for Workers' Compensation is a tremendous honor, and Chris is certainly deserving of it. She is not only an excellent care coordinator, but a true leader in her field.â€
About Genex Services, LLC
Genex Services (www.genexservices.com) is the trusted provider of workers' compensation clinical services that enables industry payers and risk managers to improve their bottom lines. Genex is the most experienced managed care provider in the industry, with more than 2,500 employees and 47 service locations throughout North America. The company serves 381 Fortune 500 companies in the U.S. In addition, Genex is the only company that delivers high quality clinical services enhanced by intelligent systems and 360-degree data analysis to achieve consistently superior results related to medical, wage loss, and productivity costs associated with claims in the workers' compensation, disability, automobile, and health care systems.
About the Case In Point Platinum Awards
The Case In Point Platinum Awards, presented by Dorland Health, highlight the innovative and creative work of individuals and organizations making a difference in today's complex healthcare system. The annual awards competition sets the standard for success across a variety of disciplines and settings in the overarching continuum of care coordination.