The equipment and supplies that injured employees receive is often thought to be less important than the medical-based care, but it is often the longest-lasting care available. This is the care that injured employees take with them into their homes and futures that will best equip their healing and an improved quality of life post-injury. As employers look for ways to both improve employees’ claim experiences while also controlling workers’ compensation costs, effectively managing durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) offers a prime opportunity to achieve both objectives.
Effective DMEPOS management matters
Equipment and supplies are a crucial component of the recovery process. Employers are responsible for providing DMEPOS to injured employees and ensuring access to proper care. It should be part of a successful workers’ compensation program for several reasons, including:
- Providing injured employees with the right medical equipment and supplies promptly and efficiently improves the likelihood they’ll follow their doctors’ orders
- Oversight of DMEPOS is critical to controlling costs. Most equipment and supplies can be purchased wholesale, and many items are available in generic versions that are equally as clinically effective
- Without the right equipment, injured employees may be at-risk of incurring additional injuries
- Smooth coordination of DMEPOS demonstrates employers’ commitment to holistic care for their injured employees. Accessing necessary medical equipment and supplies should be easy and hassle-free.
Benefits of having the right partner
Partnering with an ancillary care provider for DMEPOS program management can provide a wealth of expertise related to equipment types, supplies available on the market, and how to secure the right items, at the right time, for the best price. They can help their customers control DMEPOS-related claim expenses by applying a variety of tactics, such as:
- Pre-negotiating rates with the lowest-price wholesale suppliers of high-quality products
- Identifying equally effective generic alternatives to prescribed name-brand products and working with prescribers to secure approval for the lower-cost versions
- Exploring whether purchasing a device may be cheaper for the employer than covering an extended month-to-month rental
- Conducting retrospective reviews of DMEPOS billing to reprice out-of-network purchases and direct recurring orders to network providers
- Reaching out to injured employees to validate their ongoing need for supplies and implementing other system-driven controls to limit fraud, waste and abuse
- Bundling devices with supplies and support services at all-inclusive pricing, eliminating the need for additional approvals and claim reserves
The right partner can bring talent, resources and innovation to employer programs, and help employers reduce systemic costs, improve operational efficiencies, ensure compliance, and provide employees with clinical and logistical support.
Showing injured employees how caring counts
Our role as a DMEPOS provider is to take care of things in the background, so injured employees can prioritize caring for themselves and their families.
In one case, a Careworks client’s claim involved an employee who experienced a traumatic arm amputation. The residual limb was severely scarred, which made the provision of a prosthetic device a challenge. Careworks was tasked with coordinating an evaluation for the injured employee to receive a prosthetic. Through the Careworks Prosthetic Access program a life-care plan was developed which evaluated the medical appropriateness and the cost of the prosthetic device.
We collaborated with our network of prosthetic providers to develop a proposal with multiple cost options for the client, while keeping the employee’s prior lifestyle and commitments in mind.
People who strive to support the needs of injured employees during vulnerable and challenging times, are at the heart of all managed care programs. Everyone who is a part of our DMEPOS ancillary care program is committed to providing our clients’ injured employees with top-quality equipment and supplies and a seamless user experience.