Are you a workers' compensation case manager, claims manager or life care planner who are seeking options for their injured client? In this podcast, Heddi Silon, the director of workers compensation at Shepherd Center, discusses the admissions process for patients covered under worker’s compensation.
In this segment of Shepherd Center Radio, we discuss options for patients who need a “tune up,” those who never participated in rehabilitation, or injured workers who have previously participated in rehabilitation and are more than six months post-injury.
Selected Podcast
Rehabilitation Admissions Under Workers’ Compensation
Featured Speaker:
Heddi Silon
Heddi Silon is the Director of Workers’ Compensation at Shepherd Center. In her role, she helps staff to understand workers’ compensation and how best to facilitate relationships with the workers’ compensation community. Prior to this role, she was the director of admissions at Shepherd Center. Transcription:
Rehabilitation Admissions Under Workers’ Compensation
Melanie Cole (Host): Are you a Workers’ Compensation case manager, claims manager, or life care planner who’s seeking options for their injured client? My guest today is Heddi Silon. She’s the director of Workmen’s Compensation at Shepherd Center. Welcome to the show, Heddi. Tell us about Workmen’s Compensation and your department. What is it that you do?
Heddi Silon (Guest): One of the things that makes me valuable at the Shepherd Center is I’ve been with Shepherd nineteen years and I know a lot about the in’s and out’s of navigating the system, the different departments, and so forth. So, I am quite an asset when it comes to Work Comp, new customers contacting the Shepherd Center and requesting information or wanting to discuss a case. So, I’m able to pull so many things out of my head where we can be an option for them.
Melanie: So, people that contact you are not the patient themselves, yes?
Heddi: Well, sometimes patients do contact me when they’re seeking advice on how can they get involved in the services that Shepherd offers. We are a catastrophic hospital that can manage up to about 125-130 patients. We are licensed for a 152 beds but we also have a lot of services on outpatient basis.
Melanie: So, then, if a patient comes directly to you, would it be better for them to do that or work through a case manager, claims manager, or someone of that nature?
Heddi: It’s probably better for them to work through a medical case manager or rehab case manager. Sometimes I do have adjustors that contact me that would like an evaluation done on their patients and then I triage it to the administrative assistants who help schedule appointments. It’s probably better for the medical case manager or rehab case manager to initiate any type of contact in wanting the patient to be admitted.
Melanie: So, tell us what’s involved in a CDE or a comprehensive diagnostic evaluation?
Heddi: These types of evaluations are very in depth. Typically, they’re medico-legal when there’s an attorney involved and they’re looking at future reserves or they’re looking at settling the case. These are patients that may be several years post injury and they may be aging. So, the evaluations are pretty in depth where they evaluate the patient for new equipment; maybe some alternative therapies to help them with other medical complications as they’ve gotten older.
Melanie: Can a CDE also include the potential of a consulting physician evaluation?
Heddi: Oh, sure.
Melanie: If it’s urology or gastroenterology, tell us about what that would involve.
Heddi: We would set up with our physicians the different appointments, the medical appointments. It could be pulmonary. It could be skin and wound, urology, upper extremity, lower extremity, infection control, as well as all the therapeutic-type disciplines--speech and language, physical therapy, assisted technology, occupational, counseling, neuropsych.
Melanie: Then, tell us a little bit about Workmen’s Compensation and patients that maybe have already participated in rehabilitation or need a tune up or maybe somebody who was just recently injured. How does the process work, Heddi?
Heddi: What we require is faxed information from the referral source. So, if the patient is in the hospital, we need the hospital to fax face sheet, insurance information and medical information so that we can start our triage process. We have an admissions department and we have triage nurses that review each referral that comes in. Then, we triage it out to the appropriate access case manager. We have I believe over thirteen access case managers that cover the United States. We actually have individuals that live in Nashville, Chattanooga, Kentucky, Massachusetts, Baltimore, Florida, North and South Carolina. We are able to go outside anywhere in the United States to evaluate a patient.
Melanie: How would somebody find a case manager to work with them?
Heddi: If they’re internal in a hospital, what would probably happen is there’s going to be a medical social worker or rehab social worker. They’re also known as case managers. If it’s a Workers’ Comp, typically that person’s going to be assigned to the patient at the time of the accident or within a period of time and they introduce themselves to the family and the patient.
Melanie: And, if somebody has already had rehab but is experiencing some medical setbacks, are they eligible for this type of program as well?
Heddi: If they’re Workers’ Comp, we would need a referral from their primary doctor. If they’re at home, we would still need a referral and updated information. But, yes, we would assess the patient to see what needs they have, whether it’s inpatient or outpatient.
Melanie: So, then, wrap it up for us, Heddi. Tell us a little bit about what you tell people when they ask you about your department and what you do. Give your best advice for people who may have been injured on the job and want to know where to turn next.
Heddi: Patients that have been injured on the job are welcome to call me. I will explain the program to them and direct them to different departments in which they’re searching for services. What I do is business development, work with carriers or medical case managers that have never referred to Shepherd and try to introduce them to our line of business. We receive anywhere from 125 Work Comp patients a year. We probably have twice as many referrals and for some reason or another, they may not be appropriate to be admitted at that particular time. I do a lot of work with those carriers that may refer a patient that is not appropriate and try to educate them of what our services are so that they won’t have a bad taste in their mouth. So, next time they get a patient, they’ll know more what we can do.
Melanie: Thank you so much for being with us today, Heddi. And if you want more information for Workman’s Compensation case managers, you can call 404-350-7312. That’s 404-350-7312 at the Shepherd Center. This is Melanie Cole. You're listening to Shepherd Center Radio. For more information, you can go to www.shepherd.org. That's www.shepherd.org. Thanks so much for listening.
Rehabilitation Admissions Under Workers’ Compensation
Melanie Cole (Host): Are you a Workers’ Compensation case manager, claims manager, or life care planner who’s seeking options for their injured client? My guest today is Heddi Silon. She’s the director of Workmen’s Compensation at Shepherd Center. Welcome to the show, Heddi. Tell us about Workmen’s Compensation and your department. What is it that you do?
Heddi Silon (Guest): One of the things that makes me valuable at the Shepherd Center is I’ve been with Shepherd nineteen years and I know a lot about the in’s and out’s of navigating the system, the different departments, and so forth. So, I am quite an asset when it comes to Work Comp, new customers contacting the Shepherd Center and requesting information or wanting to discuss a case. So, I’m able to pull so many things out of my head where we can be an option for them.
Melanie: So, people that contact you are not the patient themselves, yes?
Heddi: Well, sometimes patients do contact me when they’re seeking advice on how can they get involved in the services that Shepherd offers. We are a catastrophic hospital that can manage up to about 125-130 patients. We are licensed for a 152 beds but we also have a lot of services on outpatient basis.
Melanie: So, then, if a patient comes directly to you, would it be better for them to do that or work through a case manager, claims manager, or someone of that nature?
Heddi: It’s probably better for them to work through a medical case manager or rehab case manager. Sometimes I do have adjustors that contact me that would like an evaluation done on their patients and then I triage it to the administrative assistants who help schedule appointments. It’s probably better for the medical case manager or rehab case manager to initiate any type of contact in wanting the patient to be admitted.
Melanie: So, tell us what’s involved in a CDE or a comprehensive diagnostic evaluation?
Heddi: These types of evaluations are very in depth. Typically, they’re medico-legal when there’s an attorney involved and they’re looking at future reserves or they’re looking at settling the case. These are patients that may be several years post injury and they may be aging. So, the evaluations are pretty in depth where they evaluate the patient for new equipment; maybe some alternative therapies to help them with other medical complications as they’ve gotten older.
Melanie: Can a CDE also include the potential of a consulting physician evaluation?
Heddi: Oh, sure.
Melanie: If it’s urology or gastroenterology, tell us about what that would involve.
Heddi: We would set up with our physicians the different appointments, the medical appointments. It could be pulmonary. It could be skin and wound, urology, upper extremity, lower extremity, infection control, as well as all the therapeutic-type disciplines--speech and language, physical therapy, assisted technology, occupational, counseling, neuropsych.
Melanie: Then, tell us a little bit about Workmen’s Compensation and patients that maybe have already participated in rehabilitation or need a tune up or maybe somebody who was just recently injured. How does the process work, Heddi?
Heddi: What we require is faxed information from the referral source. So, if the patient is in the hospital, we need the hospital to fax face sheet, insurance information and medical information so that we can start our triage process. We have an admissions department and we have triage nurses that review each referral that comes in. Then, we triage it out to the appropriate access case manager. We have I believe over thirteen access case managers that cover the United States. We actually have individuals that live in Nashville, Chattanooga, Kentucky, Massachusetts, Baltimore, Florida, North and South Carolina. We are able to go outside anywhere in the United States to evaluate a patient.
Melanie: How would somebody find a case manager to work with them?
Heddi: If they’re internal in a hospital, what would probably happen is there’s going to be a medical social worker or rehab social worker. They’re also known as case managers. If it’s a Workers’ Comp, typically that person’s going to be assigned to the patient at the time of the accident or within a period of time and they introduce themselves to the family and the patient.
Melanie: And, if somebody has already had rehab but is experiencing some medical setbacks, are they eligible for this type of program as well?
Heddi: If they’re Workers’ Comp, we would need a referral from their primary doctor. If they’re at home, we would still need a referral and updated information. But, yes, we would assess the patient to see what needs they have, whether it’s inpatient or outpatient.
Melanie: So, then, wrap it up for us, Heddi. Tell us a little bit about what you tell people when they ask you about your department and what you do. Give your best advice for people who may have been injured on the job and want to know where to turn next.
Heddi: Patients that have been injured on the job are welcome to call me. I will explain the program to them and direct them to different departments in which they’re searching for services. What I do is business development, work with carriers or medical case managers that have never referred to Shepherd and try to introduce them to our line of business. We receive anywhere from 125 Work Comp patients a year. We probably have twice as many referrals and for some reason or another, they may not be appropriate to be admitted at that particular time. I do a lot of work with those carriers that may refer a patient that is not appropriate and try to educate them of what our services are so that they won’t have a bad taste in their mouth. So, next time they get a patient, they’ll know more what we can do.
Melanie: Thank you so much for being with us today, Heddi. And if you want more information for Workman’s Compensation case managers, you can call 404-350-7312. That’s 404-350-7312 at the Shepherd Center. This is Melanie Cole. You're listening to Shepherd Center Radio. For more information, you can go to www.shepherd.org. That's www.shepherd.org. Thanks so much for listening.