1.
Do you
offer 800 reporting for both occupational and non-occupational claims?
2.
Where is Synchrony?
3.
What
resources are available to help manage an employee's claim?
4.
What
criteria are used to make disability determination decisions?
5.
Describe
your return-to-work programs.
6.
Do you
provide a national account services manager for both occupational and
non-occupational services?
7.
Provide
an overview of your reporting capabilities.
8.
Do you
offer FMLA administration or other absence management services?
1. Do you
offer 800 reporting for both occupational and non-occupational claims?
Yes, a single toll-free number is available to report occupational and
non-occupational claims as well as FMLA absences. Claim Reporting Centers
provide live phone coverage 24 hours a day, seven days a week. Customer Service
Representatives guide callers through the reporting process and obtain all of
the information needed to establish a claim. If it's an occupational claim, the
First Report of Injury is completed online and filed with the appropriate
state. The Customer Service Representative then electronically assigns the
claim to the appropriate
Synchrony office.
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2. Where
is Synchrony?
Fourteen workers compensation and three short term disability claim offices are
located across the country.
Synchrony teams work together to help
support customer requirements
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3. What
resources are available to help manage an employee's claim?
Synchrony employs a team approach to case management and claims
adjudication with highly skilled claim and medical resources working together
to provide administration of disability events, regardless of cause or
duration. The core team that provides day-to-day claim management activities
includes Disability and WC Case Managers and Medical Case Managers. They
work to administer both occupational and non-occupational coverages, using the
same case management approach for both types of claims. Our teams have
undergone cross training in order to understand and handle both Workers
Compensation and Disability coverages. Other resources from MetLife and
Travelers are also accessible for specialty services such as
rehabilitation and Social Security assistance.
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4. What
criteria are used to make disability determination decisions?
A Medical Case Manager reviews the claim information and provides
recommendations to the Claim Case Managers on disability duration and
appropriateness of treatment and identifies follow-up activities. The Nurse
utilizes online treatment protocols as an aid for setting recovery and
return-to-work expectations and to determine appropriate lengths of absence.
Our evaluation of each case also takes into account all of the medical
documentation, the employee's age and gender, and the duties of the job
performed by the employee, as well as the prognosis and any functional
evaluations from the treating providers.
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5.
Describe your back to work programs.
Return-to-work programs and commitment is the cornerstone of the
Synchrony
service. From the first notice, we evaluate the injury against objective
return-to-work and medical guidelines. By applying those guidelines to the work
environment, we strive to create the best possible return-to-work plan,
including a diagnosis review, treatment plan, physician management plan,
return-to-work strategy and determination of need for catastrophic team
assistance. Claim personnel work with the treating physician as appropriate to
determine return-to-work potential. On-site disability management services are
arranged if needed. For employees whose serious injury precludes the
possibility of returning to the same job, the process of vocational
rehabilitation begins when appropriate.
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6. Do you
provide a national account services manager for both occupational and
non-occupational services?
Synchrony provides a team of experts to manage integrated programs for
our customers. The team includes workers compensation claim professionals and
Claim Account Executives from Travelers and Claim Disability experts
from MetLife.
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7.
Provide an overview of your reporting capabilities.
Synchrony customers benefit from state-of-the-art technology used in
claims management. Through the use of Travelers
CARMA® system, we can
combine workers compensation, short term disability and long term disability
data, eliminating the need for employers to gather information from multiple
systems and vendors.
Synchrony integrated reports provide three levels
of information:
Detailed Operational Data; What activities are taking place
daily?
Outcomes Analysis; What impact is case management having on outcomes
and where? What is working well? Are productivity gains being achieved?
Business Metrics; What impact is
Synchrony service having on your
bottom line?
Synchrony customers have a number of different report
options such as:
Claim Detail Report; Shows a detailed list of all claimants
and helps monitor claim status and track total payments.
Claim Activity Report;
Shows the number of claims reported to track frequency and submission patterns.
Financial Summary Report; Provides a quick summary of the total, average, and
highest paid losses to monitor the severity of claims.
Claim Duration Report;
Reports the median duration of disability by year and line of business.
Claim
Lag Analysis; Shows the length of time it takes to receive claims, allowing us
to measure the effectiveness of the notification process.
Integrated Scorecard;
Presents a snapshot of all key integrated measurements to monitor the overall
plan performance at a glance.
Medical Case Management Reports are also available
to provide more detailed data on claim management outcomes.
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8. Do
you offer FMLA administration or other absence management services?
Yes, FMLA administrative services are available to
Synchrony customers
through MetLife.
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