Typical Claim Lifecycle - Workers' Compensation Board

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Typical Claim Lifecycle
Treatment
Reported to WCB
Claim Registration
More complex claims
WCB Triage
Initial Adjudication
/ Decision
Most claims
Injury
Refer
to CM?
Short term Case
Management
Long Term Case
Management
Return to
Work
Medical / Vocational
Rehabilitation
Return to
Work
Integrated Partnership Model
Employers
Accommodation
Care Providers
Treatment
WCB
Facilitation
Workers
Mitigation
WCB Corporate Plan
2014 Results
Customer Feedback
INJURED WORKERS
TL EMPLOYERS
2014 Objective
Strategic Objective
2014 Results
Service Improvement Opportunities
INJURED WORKERS
TL EMPLOYERS
Access to service
Timely follow through
}
Timeliness &
Accessibility
}
Claim Status
Accessibility
Timeliness
Simple to do business
with
1.
2.
3.
4.
Get it right the first
time
Access to service
Accessibility
Timeliness
Quick to resolve
problems
Availability & Timeliness
Communications
Timeliness
Get it right first time
Easier to do business with
Simple to do business
with
Get it right the first time
2014 RESULTS
TOP PERCEIVED STRENGTHS
WORKERS (Q3)
EMPLOYERS (Q4)
My WCB rep conducted
themselves in a professional
manner
WCB conducted themselves
in a professional manner
My WCB Rep was honest
WCB was polite
My WCB rep was polite
WCB was honest
I feel that my confidentiality
was protected
Confidentiality was
protected
2014 RESULTS
EMPLOYER - PERCEIVED SERVICE IMPROVEMENTS
What Improved?
Keep improving..
#1 Website, E-mail &
Online Services
#1 Online, E-mail,
#2 Faster response time
including call return
#2 Forms / Reduce
Paperwork
#3 Better communications
#3 Better Communications
Website Features
33% of employers believe service is improving
55% suggested specific areas to improve
2014 RESULTS
INJURED WORKER - PERCEIVED SERVICE
IMPROVEMENTS
What’s Improving?
Keep improving..
#1 Better communications
#1 Better communications
#2 Faster Response Time
including Call Return
#2 Faster Response Time
including Call Return
#3 Friendlier, helpful, more #3 Improved phone contact
professional rep
18% of injured workers believe service is improving
70% suggested specific areas to improve
2014 RESULTS
Average Duration per Time Loss Claim
Days Per TLC
40
39
38.89
38
Duration
37
37.01
37.02
36
35
34
35.35
34.67
34.16
34.88
34.10
33.49
33.11
33
32
34.44
32.08
31
30
Dec-04 Dec-05 Dec-06 Dec-07 Dec-08 Dec-09 Dec-10 Dec-11 Dec-12 Dec-13 Dec-14 Feb-15
Actual 35.35 34.16 33.49 32.08 33.11 34.10 34.67 34.44 38.89 34.88 37.01 37.02
 Primary driver of the 5Yr. trend is the
changing mix of claims in the System
 2015 objective is 34 days
2014 RESULTS
OTHER
 No. of active Employers
 No. of Workers covered
 No. of Claims reported
 No. of Fatalities
 Compensation Days Paid
 Claim Demographics
 Return to Work %
 46,656
 402,894
 35,836
 39
 443,583

 97%
Environment continues to change
ENVIRONMENT
Challenges continue to evolve
 Nature of claims
 Proactive Employers &
Workers
 Increasing Awareness
 Increasing Expectations
 Increasing Urgency
 Alignment
WCB Vision & Strategic Goal
Customer Satisfaction & Excellence in development &
delivery of Compensation/Prevention Programs and Services
Operations - Compensation Programs & Services
Optimal Recovery & Return to Work
Partnerships and
Relationships
COMMON GOALS
We will develop
Positive Relationships
and pursuit of common goals
Education & Training
CAPABILITIES
Promote readiness and alignment
Workers & Employers are equally
important
Processes
DELIVERY & EXECUTION
Continuous Improvement towards
Service Excellence
Projects & Initiatives 2015-2016
Initiative
Communications
& Accessibility
Getting it
right, timely
resolution
Easier to do
Business
Communications & Customer Experience
Improvement
(Access & Call Handling, Online Services,
Improve feedback process, WorkSafe Targeting
Strategy, Form/process simplification, Service
Levels & Standards)



Front End Process Improvements
(Wage Base Simplification, Form improvements,
Workflow Optimization)



Payment process improvements
(Direct Billing, Worker Expense processes, Care
Provider payment processes)



Healthcare Process Improvements
(Improve timeliness of access to care,
expedited access to restrictions, expedited GP
approvals)









2015 Core RTW Process Improvements
(Plan in progress)
Other required / supporting Projects
(Eg. CoR, File Release)
Secure Login
Important
updates
REPORT
INJURIES
without delay
Site Search
Easy
Shortcuts
Easy Online
Account Creation
The new wcbsask.com – Focus on Simplicity & User Experience

Register your business

Coverage

CARE PROVIDERS
WORKERS
EMPLOYERS

Roles;
Responsibilities

Treatment;
Assessment

Expedited
Appointments

Access to Information;
Privacy Concerns
Care Provider Forms;
Fact Sheets

Worker Forms; Fact
Sheets
Hearing Service
Providers

Chiropractors

Dentistry

If you’re injured
(Report an Injury)
Classification &
premium rate setting

Benefits for injured
workers

Pay Employer
Premiums

Recovery & return to
work/Worker Appeals

Reporting your payroll

Fair Practices Office

Employer
responsibilities


Reporting &
Managing your
worker’s injury


Employer Appeals

Exercise Therapists

Access to Information;
Privacy Concerns

Massage Therapist

Nurse Practitioner

Fair Practices Office


Frequently Asked
Questions (FAQs)
Occupational
Therapists

Optometrists

Employer Forms &;
Fact Sheets

Physical Therapists

Physicians

Psychologists
Build on Current
Capabilities
Developing our Online
Channels
http://www.wcbsask.com
http://www.wcbsask.com
Use the Secure Login Tab
to access our portal
1
2
Login with your
WCB account
FIRST TIME USER?
create an
account here
Got a
question?
Need detailed
instructions?
Creating an
account gives you
access to claim
status
Get everything in
one place
3
Accessing online Self Service at www.wcbsask.com
17
http://www.wcbsask.com/WORKERS
2
1
3
4
Easy
printing
18
http://www.wcbsask.com/WORKERS
1
Search by account
or claim number
2
Easy access to
transactions
3
Self Serve = 24x7 access to all info - no need to call in, no need to wait…
19
http://www.wcbsask.com/EMPLOYERS
1
ONLINE SUBMISSIONS work much FASTER than
completing the PDF, FAX or phone
IMPORTANT Your Payroll / HR department
should be notified that WCB may require
further information about the Injured
Worker’s wages to process a claim.
2
Logging in first makes tracking the claim
within your account much easier
3
4
Easy review & reprinting
reduces load on staff and
simplifies paperwork
DID YOU KNOW?
INJURIES MUST BE REPORTED
TO WCB WITHIN
5 DAYS!
20
http://www.wcbsask.com/CARE-PROVIDERS
3
4
Full suite of Care
Provider Services
Convenient access to
Manuals & Guides
Accessing WCB Online Services for Care Providers
21
http://www.wcbsask.com/CARE-PROVIDERS
1
Auto-population
feature saves you time
IMPORTANT: Care Providers must login
first to access the appropriate Injury
Reporting forms.
Care Providers - Submitting an Injury Report online - 1
22
http://www.wcbsask.com/CARE-PROVIDERS
1
2
3
4
Care Providers - Submitting an Injury Report online - 2
23
http://www.wcbsask.com/CARE-PROVIDERS
1
2
3
4
Progress & Discharge Reports are just as simple..
24
http://www.wcbsask.com/CARE-PROVIDERS
1
2
3
4
Submitting a Return to Work Report Online
25
http://www.wcbsask.com/CARE-PROVIDERS
1
2
3
Provide Treatment Updates as workers progress..
26
http://www.wcbsask.com/CARE-PROVIDERS
Quick access to all Worker / Case Related Information in one place
27
e-mail
gtopp@wcbsask.com
bdsena@wcbsask.com
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