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TravComp®, Travelers' workers compensation claim management solution, is recognized as the industry's most advanced approach to managing workers compensation claims. It joins together the specialization of co-located medical and claim professionals to promptly handle, thoroughly investigate, and fairly resolve your workers compensation claims. The result: a workers compensation claims management solution that meets your unique business needs.
TravComp® combines state-of-the-art technology, trained claim and medical professionals, and quality standards to help ensure that each and every file is managed effectively and fairly. Our mission has been and remains returning injured employees to their jobs, assuring quality medical treatment for injured employees, and generating significant total loss cost savings for our customers. We are confident that our TravComp® design allows us to meet and exceed that mission for our customers.
Early intervention on all new claims has proven to have a positive impact on length of disability and ultimately, claim payout. Timely recognition and reporting of workplace incidents to our toll-free claim reporting number:
Our expansive medical network is an integral part of TravComp®. With presence in all 50 states and the District of Columbia, Travelers' preferred provider network (PPN) covers the working population with discounts averaging almost 20% below fee schedules and reasonable and customary charges. The network adheres to strict credentialing and medical guidelines designed to return the injured worker to productive employment. The network was constructed by medical and claim professionals to treat workers compensation-specific illnesses and injuries to achieve early return-to-work at the fairest cost. Travelers' medical management services division uses the following mechanisms to encourage injured employees to use the preferred provider network unless specialized medical services are not available:
Travelers' pharmacy management network is specifically designed for workers compensation so that the injured worker obtains the appropriate amount of medicine at a fair unit price. To reduce overuse, misfills, early refills, drug interactions, and payment for unrelated drugs, our system compares all drug requests against currently prescribed medications for dangerous interactions and early refills.
Our pharmacy vendor for these programs, HealthE Systems, is a national network designed to facilitate rapid procurement of necessary drugs to the treating injured worker at the retail pharmacy. This vendor also offers a mail order/home delivery program to serve injured workers in long-term treatment.
The medical management process is initiated by the TravComp® team in each local claim office. Case management nurses use knowledge-based medical protocols to effectively control medical payout and indemnity lost time. They make case-by-case decisions based on a vast array of medical resources as well as the effect the treatment will have on the return-to-work plan.
The nurse works together with the claim case manager and all involved parties, communicating with both the employer and the injured employee.
Travelers' Medical Bill Management (MBM) system is an integrated program, self-contained in our overall claim management process. Bills are scanned, processed, and paid without leaving our facilities to ensure accuracy in our data, payment, and re-pricing. Our MBM system contains a clinically-oriented claim auditing feature that is designed to detect inappropriate billing practices. The system analyzes the relationship between procedure costs and/or diagnosis based on reasonable, usual, and customary pricing or state fee schedule guidelines, procedure relatedness, medical necessity, and appropriateness. The system also warns us when special actions such as pre-authorizations are required, and detects many different types of code manipulation practices, including:
We continually enhance our detection capabilities through upgrading our state-of-the-art rules and clinical edit system. The services we provide are:
Return-to-work programs are the cornerstone of TravComp®. From first notice, we evaluate the injury against objective return-to-work and medical criteria. Claim case managers contact the employee, employer, and treating physician within 24 hours of the claim notice to determine the facts of the case, compensability, and an effective return-to-work program as necessary. These return-to-work plans include a diagnosis review, treatment plan, return-to-work strategy, physician management plan, and determination of need for catastrophic team assistance. Our medical team then works with the treating physician to assist them with return-to-work possibilities.
Travelers is also committed to actively engaging injured employees in their return-to-work planning. Travelers is the first workers compensation carrier to bring information directly to the injured employee in a clear and comprehensive format via the internet. At www.mywcinfo.com, employees can review their claim payment history in a secure, online environment, access state benefit information, and obtain medical self-care tips and workers compensation reference material. The site also offers a Spanish translation option.