Self-insured employers managing absence and short-term disability (STD) claims have no shortage of tasks on their plates. In addition to day-to-day responsibilities, they take on the responsibility of ensuring these claims are adjudicated fairly and in a timely manner.  But how is this best done effectively, and in alignment with regulatory compliance and bias-free management?

At Bridges Health, we’re your reliable partner in fairly adjudicating and managing STD claims. We’re here to support employers whether they need a software solution to help track and manage their claims, or to support entire claims process. Key to avoiding potential bias is ensuring consistent, dedication resources, and capturing complete data in the claims process. Below, we’ll explore how Bridges Health works alongside employers like you to ensure effective, dignified case management.

Why Employers Struggle with Self-Adjudication

Today’s workplaces are incredibly diverse, whether it’s crown corporations, unionized workplaces, non-profit organizations, or others. Partnering with a professional third party helps ensure complete, fair representation for employers and employees alike, free of bias and most importantly, privacy issues. However, plenty of employers do self-manage, but it’s important to have a partner for critical activities.  At Bridges Health, we have a “got it alone” support strategy, or “gain a partner” strategy. Both offer employers the confidence to build a strong and effective internal program with ability to involve a partner like Bridges Health when claims are complex or an additional assessment is needed such as an independent medical examination. Bridges Health adjudication services, combined with comprehensive mental health case management ensures holistic organizational support.

Ensuring equity and inclusivity is essential for organizations today. Employers with self-insured absence management programs should ask themselves several questions, including:

• Are those managing the claims trained in equity-based adjudication?
• How are we identifying and preventing conscious and unconscious bias?
• How are we ensuring full privacy compliance?
• How are we eliminating communication barriers with all parties?
• Is there a consistent process for every claim being adjudicated?

Navigating Mental Health Claims with Structure and Compassion

Mental health claims are among the most prominent STD claims in Canada. It’s clear to see why. Over the last several years, mental health-related disabilities have continued to rise exponentially. In 2022, the prevalence of mental health-related disabilities rose to 39% in working-age adults. Workplaces are already seeing this trend in action. The year prior, mental-health related claims rose 6%, and overall absence durations increased by 12% on a national scale.

Employers must act proactively, especially those administering claims in-house. It’s easy to overlook the challenges that mental health claims pose to employers, but they’re present nonetheless. Healthcare providers can be challenged to supply sufficient restrictions and limitations and active monitoring of treatment plans is important to move towards a return to health and eventual return to work.  Fortunately, Bridges Health is here to effectively managed these claims with our data-driven approach. 

A Steadfast Partner with 30 years Experience

For absence and accommodation cases, it’s standard practice to see a health professional before adjudication can proceed. Despite this, employers frequently get medical notes that support an absence or accommodation without sufficient functional restrictions and limitations to support. In the absence of an effective strategy to follow up and focus on the medical rationale for the absence or accommodation, an employer may not be able to understand why there is an impact to the employee’s job duties.

At Bridges Health, we take a collaborative approach to our adjudication services. Our consultants support organizational goals by monitoring and focusing on treatment and health outcomes. It’s important to respectfully challenge medical professionals on their recommendations, ensuring clinical justification and measurable outcomes. 

Transparent Case Management for Smarter Decisions

Workplaces that enact robust workplace injury tools have seen substantial increases in employee retention, safety, and productivity—up to 20% or more for both sickness and injuries. At Bridges Health, we monitor our adjudication services extensively through the WorldWorks360 software program. All case-specific details, including case management notes, communication with healthcare providers, and appointment follow-ups, are here. WorldWorks360 allows us to track everything related to your case effectively, ensuring cases are adjudicated and managed promptly.

Your Partner for Informed Adjudication Services

Bridges Health is a wholely owned Canadian supplier of comprehensive workplace health and wellness solutions. Our strategic, yet responsive approach to managing occupational and non-occupational claims ensures employers and employees are supported throughout the process. 

Contact us today to learn more about how Bridges Health can help you reduce workplace absenteeism, manage adjudication services, and support return-to-work initiatives!