Medical Program Solutions

Continuum of Care

ESIS’ Continuum of Care connects every stage of the claim journey into one coordinated experience. From first notice of loss through medical management, recovery, and return-to-work, ESIS’ integrated teams combine clinical guidance, claims expertise, technology and advanced analytics to proactively guide each claim toward the best possible outcome — for both injured employees and our client.

ESIS medical programs are built on three principles:

  1. Integrety: Which is about building trust through bringing the best programs and partners to the table to meet your clients' needs while also being transparent with your programs' outcomes
  2. Innovation: Searching the market for what's new and testing so you don't have to; example (Virtual Reality, Wearables) and pushing our existing partners to continuosly improve the claim process and demostrate differentiation.
  3. Impact: To deliver what Ecplise Advantage and ESIS expect for a strong return on investment.

Using these principles, we've developed a continuum of care that categorizes our programs into four broad areas.

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Paychex, a valued ESIS client

“Our experience working with ESIS has been nothing short of phenomenal”

 Mark Rodefeld, Director of Risk for Paychex PEO 

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ESIS Medical Impact provides a suite of medical programs and extensive clinical resources to ensure clients have access to the highest quality of care. This approach minimizes loss costs and helps return injured employees back to good health, and then work.

  • ESIS medical review and PPO resulted in total savings of more than $1 billion annually
  • ESIS blocked $8 million in pharmacy prescriptions that were outside our customized formulary
  • 83% of injured workers return to work through ESIS’ field case management services
  • ESIS’ PPO savings from original billed charges exceeded our competition by 56.2% (17.9% vs. 11.5%)

Clinical Resources

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Outcomes Based Network: ESIS ExPO®

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Medical Bill Review

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Preferred Provider Networks

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Pharmacy Benefit Management

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Quality Assurance: Medical Impact Managers

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Whitepaper

Managing the medical component of workers compensation costs

Learn how bill review, case management, and data analysis can produce dramatically improved results when accessed via an integrated claims management approach.

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