WCC provides comprehensive and professional case management assistance that is focused on providing quality service to injured Federal employees while reducing program costs and the time that employees are away from work. We ensure that, where appropriate, a nurse works with our case managers to facilitate appropriate medical care, identify obstacles to recovery and ultimately focus on returning an individual to work.
WCC monitors the disability management process to ensure compliance with on-going submission of medical records with updated physician statements along with any changes in the medical status of the employee. Our case managers develop positive relationships communicating directly with Federal employees, medical providers and agency management. Our guiding principles are outstanding customer service for injured and ill employees and early intervention to ensure a proactive approach for the Agencies we service.
Our Medical Review Team is comprised of subject matter experts across the field of medical professions (e.g., nurse RN’s, licensed physicians from different specialties, surgeons, certified medical coders, medical case managers, etc.). Our staff is skilled in OWCP FECA Program and CMS Medicare and Medicaid coverage guidelines and payment methodologies. We support our CMS prime contractors and OWCP Federal Agency clients in analyzing each medical claim. Our Medical Review Physicians provide case evaluation and medical record review so that WCC case managers can determine the next steps to take with a focus on appropriate medical care and return-to-work, if applicable.
WCC supports its CMS prime contractors and Federal agency clients by ensuring that payments made are in fact appropriate and identifies potential improper, fraud or abuse situations. We use data analysis techniques and statistical methods to detect aberrancies, trends and patterns in claims data and determine that payments are appropriate and comply with applicable laws, guidelines, policies and regulations
Our practical knowledge of federal agencies and review of medical claims is a perfect fit to support CMS and its various fraud initiatives. Our staff of program integrity analysts, including accredited Certified Fraud Examiners (CFE’s) have experience and proven success in conducting various healthcare compliance audits, field investigations and reviews, achieving measurable results and determining an appropriate course of action for each case.
WCC, a leader in Federal Health Programs and Workers’ Compensation has demonstrated and proven its technical ability in conducting reviews of complex, lost-time, long-term and periodic roll OWCP claims. WCC’s staff of FECA subject matter experts for over 10 years have provided full cycle claims management for OWCP FECA claims identifying and returning significant savings in the areas of compensation and medical cost savings.
The costs associated with disability due to work-related injuries can be significant. Working together with agency management and medical providers, WCC has been able to positively impact the management of its clients’ programs by implementing a return to work programs with transitional duty and bringing employees back to work quickly. WCC’s return to work program reduces disability and medical costs to an Agency by intervening as soon as an injury occurs and assisting employees early in the recovery process.
WCC works with federal agencies and other partners to develop and provide standard, customized and on-demand training programs. WCC covers training areas such as an overview of FECA for first-line supervisors as well as processes and procedures for senior-level managers.
7010 Little River Turnpike, Suite 450 Annandale, VA 22003
Phone: (703) 663-7305 | Fax: (703) 941-8965
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