Testimonial "Prognos has allowed my team to focus on managing claims and getting employees back to work instead of administrative activities. The reporting and management tools available in Prognos have enabled us to measure and justify the new programs we have worked to get approved and implemented. If we didn't have Prognos, we could not produce reports of this accuracy and quality required to evaluate our programs and measure performance." University Manager, Integrated Disability, Unemployment and Benefits

A large public University with over 40,000 students, faculty and staff. With tens of thousands of people on campus, this University has created its own “city within a city.” In addition to educating its growing student base, the University also employs a large staff which includes a police force, medical center, custodial and maintenance staff, faculty, as well as, administrative associates.

The Challenge

The University's manager of integrated disability, unemployment and benefits needed a solution to assist her in managing over 1,300 workers' compensation and disability claims the university experiences annually.

Before PureSafety's Prognos™ software was introduced, all workers' compensation and long-term disability (LTD) case management was handled using hand-written forms and stored in paper files. Due to this labor intensive manual process, a separate department handled short-term disability (STD). This manual process led to numerous inefficiencies and problems, including:

Poor Organization – Employees had difficulty finding information and tracking cases.

No Search Capabilities – Because the program was paper-based, employees were required to manually review paper files, documents and notes to find the information they were looking for regarding each case.

Difficult to Monitor Double-Dipping - With a paper-based system, monitoring the programs and identifying employees receiving multiple benefits was a difficult, if not an impossible task.

Difficult and Time - Consuming Data Entry and Reporting – Reporting processes were also labor intensive and typically required a number of entry level file clerks, which significantly increased labor costs.

Manual Tracking of Claim Costs and Payments - Tracking claim costs manually made it difficult to efficiently review claim payments and virtually impossible to create cost- based reports for analyzing trends and identifying problem claims.

Delayed Claims – The manual process caused delays in the submission and management of claims, which resulted in unnecessary expenses.

The Solution

In order to improve its case management capabilities and processes, the University implemented Prognos™ in 1995. This started a long-term “partnership” between the two organizations. As the University's needs have grown over the years, so has Prognos™. The University has been instrumental in providing valuable feedback and guidance that has helped to shape and improve the Prognos™ solution.

In the beginning, the Prognos™ solution was put in place to simplify and organize its workers' compensation and long-term disability programs. Once they discovered the efficiencies the software provided, they expanded the use of Prognos™ to include the management of short-term disability (STD) claims, safety management and OSHA recordkeeping. The University is currently evaluating the possibility of integrating Prognos™ capabilities for Family Medical Leave (FML) administration to their configuration.

The Results

Since implementing Prognos™, the University has significantly improved workflow management and reduced costs. Some of the many benefits the organization has experienced are outlined below:

More Consistency & Efficiency
Prognos™ has eliminated the need for paper files for the approximately 1,300 annual claims. Along with their regular modules, the University is using Prognos' imaging solution. This allows all hardcopy documents to be scanned and filed within a digital case file. Before Prognos™, the University was receiving 300-400 pieces of paper related to claims every day! With Prognos™, they have all but eliminated the need for paper copies, which has resulted in the reduction of between 60,000 and 70,000 pages per year. In addition to reducing the use of paper files and providing easy access to electronic claims files, integrated workflow tools enable case managers to quickly access and review new documents as they are indexed to their case files.

Searchable Databases
Prognos'™ centralized database makes it convenient for case managers to search through case information and quickly find what they are looking for. This includes medical reports, billing information, claim history, transitional work data and much more. Case managers can also search ICD-9 codes and access integrated Official Disability Guidelines (ODG) from the Work Loss Institute directly from within Prognos™.

Ability and Resources to Create Transitional Work Program
At the University's request, PureSafety was able to enhance the Prognos™ module for tracking and managing transitional work programs. The transitional work program helps case managers track and manage alternative work for employees on light or limited duty due to a medical condition, allowing them to remain a productive asset to the University throughout their recovery period.

This Transitional Work Program, managed and measured using the Prognos™ platform saved the University over $1.4 million and 15,000 lost days in the first eight months of 2007.

Improved Tracking and Reporting of Claims and Costs
The Prognos™ Report Wizard provides instant access to hundreds of report templates that have proven to be an integral part of the program's success. Interactive reporting tools allow the University to accurately measure and evaluate all aspects of their claims including rates, severity, lost time, and much more.

The University also uses Prognos™ and its integrated ODG guidelines to rank the hospitals, physicians, and case managers treating their injured employees. Oftentimes, they will meet with physicians to review the reports and discuss both the positive and negative implications. By educating doctors on the importance of rapid return-to-work and transitional work management, the University is getting its doctors to act in the best interests of both the patient and the University.