| |
Claims Management Services
ESIS Impact®
Workers Compensation
Liability
Integrated Disability Management
ESIS Impact®
ESIS Impact®, our distinctive approach to claim management, combines people, process, and technology in an architecture that incorporates a dynamic intake process; designated claim teams; our select, outcome-based provider network tool; proprietary medical and pharmacy programs; contemporary return to work tools; health, safety, and environmental services; and analytics to demonstrate results.
Benefits
- Advanced intake environment using predictive triage
- Aggressive medical only management validates treatment
- Clinical triage at intake and throughout the life of the claim
- Proprietary medical management solution
- Exclusive, outcomes-based provider network and selection tool, ESIS ExPO®
- Proprietary pharmacy benefit management program
- Comprehensive approach to client benchmarking, Analytics in Action®
Results
Though a comparison study for recently transitioned accounts from other large, national TPAs, ESIS identified the following benefits realized through ESIS Impact®:
- Achieved a total average reduction of 12 percent
- Achieved a higher rate of closed indemnity claims
- Decreased the average paid per claim across all claim types, down 12 percent overall
- Achieved a three percent reduction in indemnity claims
- Significantly decreased the average age of medical only claims
- Significantly decreased the average paid per claim rates on medical only claims
Workers Compensation
Business owners, managers, and supervisors know all too well the consequences that come when workers compensation costs go awry. At ESIS, we are committed to helping our clients implement best practice procedures to address this issue. From years of experience, we’ve learned that sharing common goals to reduce workers compensation costs provides visible benefits to our clients, and we have developed an innovative approach to help businesses harness escalating workers compensation costs.
Benefits
- Proprietary medical management solution
- Clinical triage at intake and mid-case
- Intake services available 24 hours per day, 7 days per week
- Flexible services, based on established best practices
- Comprehensive disability management/return to work philosophy
Liability
ESIS performs claims management services for a broad spectrum of standard casualty insurance products, including general liability, automobile liability, product liability, professional liability, and medical malpractice.
Benefits
- Team of specialists handling automobile liability, general liability, and product liability bodily injury claims
- Internal center specializing in quick resolution of routine premises-operations claims
- Special Investigation Unit to deal with suspected insurance fraud
- Automobile, truck, and heavy equipment appraisal services facility specializing in physical damage management
- National catastrophe team
- Offices specializing in the handling of construction claims
Service Enhancements
- Factual investigation — our plan of action is based on best practices, then tailored to the specific requirements of your claim
- Damage investigation — we carefully examine the injury or property damage to determine how we proceed to evaluation and negotiation or denial
- Evaluation — we recognize that evaluating every facet of the claim and establishing a dollar value for settlement is critical
Integrated Disability Management
Seeking lower costs and higher productivity, employers today use a variety of programs and practices to deliver health, disability, and absence benefits across traditional benefits lines. ESIS sets the standard for workers compensation claim management, as we have for close to 50 years. For IDM and other health and productivity management programs, we team with the nation’s leading case management services provider to produce consistently positive outcomes for your business’ sick and injured employees.
Benefits
- Common return to work program for occupational and off-the-job injuries
- Integrated case management to treat injuries the same regardless of cause
- A common intake system for all disabilities and absence
|
|
|