Much has been said about new and innovative approaches to Durable Medical Equipment (DME) and ancillary service programs, and Coventry's DMEplus® program's approach is no exception.  Our clinical approach to care helps adjusters make appropriate decisions on their most complex claims.  The DMEplus dedicated clinical team of nurses assists adjusters in identifying the right product or service for these injured workers, specifically on high dollar and complex cases.  Our nurses collect all the pertinent clinical information, including physician and nurse notes, and provide the adjuster with a complete picture of the injured worker including:

• Injured worker background information
• Year-to-date spend on DME, home health, and pharmacy
• Physical assessment
• Functional assessment
• List of current DME equipment, home health and medications
• Follow-up recommendations

Once collected, we can proactively setup time to go over the information with the adjuster to ensure that appropriate services are provided.  In addition, we work closely with the case manager, family or care giver to help them understand the nature of the injury.

If an injured worker is hospitalized our hospital discharge planning program prepares for the discharge in advance so all their needs are meet in a timely manner.  We facilitate the discharge process from start to finish, and managed over 4,000 requests in 2013.

Working closely with our home health specialists not only ensures the appropriate items are provided, but saves the adjuster time.  Adjusters can spend 24 to 48 hours coordinating in-home health services and hospital discharge, and several weeks for prosthetics and home modifications.  With DMEplus we take care of this for you!

In addition to providing a one-stop clinically focused program saving our clients valuable time, DMEplus also offers a clinical management  and oversight program that identifies opportunities for additional savings of as much as 15% to 30% on total spend.  We also pride ourselves in the level of care we provide the injured worker.  We collect injured worker feedback when our services are complete and are pleased to share our 95% satisfaction rate!

For more information on how DMEplus can work for you, please contact your local Account Sales Manager (ASM).