SCENE 1: Lifecycle of an Injury Through the Digital Platform
Let us visualize the platform we introduced through the following scene.

Here is Freddy. Freddy is late for his next meeting at the other end of the building. Freddy is running through the hallway, which is a safety violation, to begin with. Someone dropped a pen and did not realize it. Freddy slips on the pen and falls backward onto his back.

SCENE 2: Incident Report, Investigation and OSHA Reporting
Utilizing the Health and Safety Module, Freddy can log this incident directly into Emidence XD through a self-service portal authorized by the employer. Freddy’s risk manager pulls Freddy’s employee demographic information from the human resource system and is guided through a series of questions to gather pertinent information to send to the employer’s carrier or third-party administrator. The third-party administrator will load the injury detail into the claims management system to establish a claim or report the only incident.

If it is determined that this is an OSHA reportable event and that medical care is needed, the injured employee will be referred to a care clinic. The required OSHA form, 300, 301, 300A,  will be auto populated by the system with the information gathered. The OSHA team can review and auto-upload the reports into the OSHA portal.

Freddy’s supervisor can initiate an investigation using Emidence XD’s inspection and CAPA modules, close the inspection, put corrective actions and new training in place by using Emidence XD’s ECM module.

SCENE 3: Case Management, Return to Work and Industrial Hygiene
Emidence XD Case management module automatically creates a case and is immediately available to the case managers.

• Case managers can log all communications, SMS text send from the platform into the database.
• The built-in ODG (Occupational Disability Guideline) provides planning guidelines for absence and Return-to-work estimates.
• Built-in job requirements in Emidence XD help the case manager find alternate jobs for the person if not able to meet the requirements of the original job pre-injury.
• Industrial Hygiene can carry out the investigation, if needed, and close the case.
• Environmental screening, monitoring, respiratory, and hearing PPEs can be issued and fitted using Emidence XD’s Industrial Hygiene and Inventory modules.

SCENE 4: Patient Portal & Physician Office Visit and the Encounter
The injured employee will visit the patient portal of the physician’s practice management system to pre-fill basic health information. Details about the injury are automatically pulled into the physician’s system through our integrated model.

• Pre-populating the OSHA form saves administrative hours and ensures compliance.
• Pre-populating the physician system via the patient portal saves employee time and facilitates a smoother office visit.

The physician will sign into the practice management module and be guided through a series of evidence-based, injury-specific guidelines. When the physician completes the assessment, the physician will lock the record and automatically send the medical bill and medical notes through the billing platform electronically to the carrier or third-party administrator.

• The evidence-based, injury-specific guidelines embedded in the system guarantees a clean medical bill is populated when the encounter is complete.
• Locking the record immediately after the encounter and automatically submitting it to the billing team reduces transcription hours and facilitates the prompt filing and faster time to payment.
• Automatic submission of the bill to the payor eliminates the printing and faxing of medical notes as well as follow-up calls requesting missing notes. Administrative time is saved as well as administrative costs.

SCENE 5 & 6: Bill Received by Payor and Sent to Medical Bill Review
The carrier will log back into the claims platform and see that a bill has been received.

• The carrier may set up a claim or link the bill to an established claim.
• The carrier electronically sends the medical bill and notes to bill review.
• Once the bill is released to the medical bill review engine, the bill will be evaluated further for carrier-specific business rules, state rules, network application, and recommendation of payment.

The integrated system enables the carrier to see the stage the employee is in throughout the lifecycle of the claim.

• Reduces lost bills and associated documents by linking all associated bills and notes to the employee systematically.
• The reduction of paper handling and associated administrative tasks associated to mailroom functions are decreased.
• Medical Bill review is completed more quickly, enabling faster payments and in some cases, return-to-work.

The carrier will release payment to the provider and attach to the claim file within the claims management system the documentation supporting payment.

Conclusion
What does all of this mean for you? No matter what role you play within the workers’ comp system, we have created a way that you can have a holistic view of the employee through the WC system, pre, and post injury.

• Xybion’s combined solution is more powerful than any competition Xybion offers a total end-to-end solution powered by one source of truth. Gone are the days of merging data from multiple sources and piecing together multiple solutions.
• Xybion bridges the gap between stakeholders delivering customized solutions from one cloud – one core database – with multiple interconnected apps.