What We Do
OccMD Services
OccMD provides a medical management model in which an employer’s third-party claims administrator or in-house claims team refers complex injury issues or claims to a physician medical director for advice and support on selection and accountability of specialist medical providers and nurse case management.
Clients utilize the experience of the OccMD team to help injured workers get better, faster, with evidence-based claim file reviews, second opinions, independent medical examinations and nurse case management services for thousands of occupational injury claims annually. These services include:
Medical Director Services that timely access the most qualified specialists on complex claims, and ensure an accurate assessment of the extent of injury and appropriate use of medical and disability guidelines. Instead of serving as a treating provider, the Medical Director continually monitors common areas of provider abuse (like early MRI’s, excessive physical therapy and opioids), prescribing patterns, surgical re-do rates, and employee satisfaction. With an exceptional team, good communication skills, and better use of all available tools, OccMD’s medical management model substantially outperforms other workers’ comp and injury benefit programs.
Nurse Case Management Services, including telephonic and field work, with Medical Director oversight. This includes timely gathering all information available (like past and current treatment records, injury reports, and interviews); making medical care arrangements; watching for excessive office visits, add-on body regions and inflated diagnostic labeling; maintaining contact with all involved parties; and acting as the injured worker’s advocate. With the physician support and direction they need, our nurses do a better job of timely achieving demonstrable progress and injured worker recovery.
Other Specialty Services including:
Provider Networks
OccMD has agreements with a broad range of medical specialists who ascribe to the same philosophies of patient care that OccMD does: getting the patient back to the highest level of functionality in the shortest period of time and using activity such as going back to work as a treatment modality. Many specialists do not accept workers' compensation cases—but they do work with OccMD and Dr. Tonn exclusively on occupational injury cases. These specialists know that OccMD expects an evidence-based approach and open timely communication.
Prescription Formulary
OccMD has identified medications that are routinely prescribed for work injuries and need special authorization prior to dispensing.
Causation Reports / Peer Reviews / File Reviews
OccMD refers complex work injury cases to leading medical specialists for review early in the claim process to determine whether the mechanism of injury would reasonably result in the assigned diagnoses. This helps injured workers receive the appropriate level of medical care from the best source and assists employers in determining their claim liability. OccMD ensures that while this process is occurring, necessary medical care is not delayed. We also do claim file reviews, produce evidence-based medical reports, obtain second medical opinions and independent medical exams, and provide pre-authorizations for third-party utilization review (UR) agents.
Pharmacy Medical Director
Dr. Tonn serves as the medical director for immunization programs.
Fee Negotiation
For claims involving scheduled surgeries, inpatient rehabilitation or other specialty services, OccMD negotiates with physicians and medical facilities to arrive at a reimbursement agreeable to all parties.
OccMD has been successful through a combination of:
Knowledge of medical practice patterns for occupational medicine providers
Credibility with those medical providers
Ability to identify opportunities for improvement in occupational injury management inside and outside of workers’ compensation systems
Communication skills
An exceptional team
The Evidence is in Our Outcomes
The OccMD approach to medical management reduces “adverse surprise” cases, and results in better medical outcomes, with higher overall employee satisfaction.
The Proof is in the Outcomes
