Workers' Comp
Office Policy on
Workmans' Compensation Patients
The Doctors and Staff of CNOS thank you for choosing us to provide medical care for your injured workers. We have built a reputation over the last 7 years of providing excellent patient care and accurate medical information to the adjusters, attorneys, case managers and vocational rehabilitation specialists who are also involved with our patients.
Workers' Compensation Physician Team
Michael Genoff, M.D.
Orthopaedics - Hand Surgery
"Patients' hands are the main tools in the industrial world and our goal is to help them obtain the highest possible function after an injury."
Grant Shumaker, M.D.
Neurosurgery - Spine
"Spine Surgery recommendations are based on increased ability outcomes, not disability."
Steven Stokesbary, M.D.
Orthopaedics - General
"As a sports medicine physician, I try to implement that same medical philosopy to workers' comp injuries."
Raymond Emerson, M.D.
Orthopaedics - Clinical
"My main concern is an early diagnosis and proper treatment for people with work related events or injuries."
Workers' Compensation Team
Cindy Vergith
Work Comp, Coordinator
605.217.2688
cindy.vergith@cnos.net
Chad Behrend, WCLS
Work Comp, Accounts Manager
605.217.2684
chad.behrend@cnos.net
Philosophy
Our primary goal is injury management. The patient will have access, given approval, to the most up to date diagnostic, surgical and therapeutic modalities available to insure their recovery and return to maximum function in the shortest time. We feel this approach is the only way to secure the best outcome for both the patient and their employer.We are patient advocates.Our philosophy is to believe the patient about the nature of their injuries, symptoms, abilities and outcomes. If the patient says, “I hurt and I can not do a task” we will believe that patient unless there is objective evidence, such as signed testimonials or videotape, to the contrary.
We are employer advocates. We strive to return patients to limited or full duty as soon as their medical condition and the requirements of the workplace will allow. We will not allow patients to return to a workplace without the assurance that the restrictions we have outlined will be followed nor will we allow patients to remain at home if a suitable light duty or modified job, which will not aggravate their condition, is available.
We are advocates of insurers. Our testing, procedures and therapy is limited to that which is medically necessary given the patient’s injury, symptoms and progress. We will not ignore a patient’s complaint if they seem to be work related. We are aware that their are other practitioners, less skilled than ourselves, who will seize the opportunity to treat a patient knowing that the current legal system will usually reimburse them for medical care given. Patients who have received their care outside of our office are often referred in, after the fact, at which time we can only attempt to provide conservative treatment or assist the process of vocational rehabilitation and return to work.
We are attorney advocates. We work with both plaintiff and defense counsel to educate them on the medical condition of the patient, our opinions regarding causation and prognosis and other areas of the patient’s care.
We advocate for the vocational rehabilitation and case management process. We are available for meetings with all interested parties, in the setting of a rehabilitation conference, to discuss the progress, prognosis and return to work of any of our patients.
And finally we must be advocates for our own interests. Patients involved in a workman’s compensation claim are more difficult to treat than those with indemnity insurance. Almost every study looking at the outcomes of injuries and treatments has shown they these individuals do worse than the general population in both length of treatment and final outcome. There is an increased clinical and administrative workload that is involved in the care of these patients that may or may not be completely offset by the increased reimbursements provided. In order to continue treating these patients we must bill (and expect payment) for all additional services provided including additional forms and paperwork, meetings or communications with employers, case managers or attorneys and the review of any extraneous materials, documents, images or video.
Medical Records
In order to provide the complete, thorough and in-depth evaluations that are required for patients all medical records must be available for review no later than one week prior to the patient’s visit. Patients whose medical records are not available one week prior to their appointment may be rescheduled to allow the records to be reviewed, organized and summarized or their initial reports may be inconclusive or incomplete requiring additional reports at an additional cost.
Billing
Our billings are based either on our usual and customary charges or the applicable fee schedule whichever is less. For those items that have no set fee or are billed “By Report” our charges will be based on the time involved by our physicians and staff multiplied by an appropriate hourly rate.
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