CorVel is a national provider of workers’ compensation solutions for
employers, third party administrators, insurance companies, and government agencies
seeking to control costs and promote positive outcomes. The Company applies
technology, intelligence, and a human touch to the challenges of risk management
so that their clients can intervene early and often while being connected to
the critical intelligence they need to proactively manage risk. CorVel specializes
in applying advanced communication and information technology to improve healthcare
management for workers’ compensation, group health, auto and liability
claims management. With a technology platform at its core, the Company’s
connected solution is delivered by a national team of associates who are committed
to helping clients deliver programs that meet their organization’s performance
goals.
The Company’s services include claims management, bill review, preferred
provider networks, utilization management, case management, pharmacy services,
directed care and Medicare services. CorVel offers its services as a bundled
solution (i.e. claims management), as a standalone service, or as add-on services
to existing customers. Customers of the Company that do not purchase a bundled
solution generally use another provider, use an in-house solution, or choose
not to utilize such a service to manage their workers’ compensation costs.
When customers purchase several products from CorVel, the pricing of the products
sold is generally the same as if the product were sold on an individual basis.
Bundled products are generally delivered in the same accounting period.
Workers’ compensation is a federally mandated, state-legislated insurance
program that requires employers to fund medical expenses, lost wages and other
costs resulting from work-related injuries and illnesses. Workers’ compensation
benefits and arrangements vary extensively on a state-by-state basis and are
often highly complex. State statutes and court decisions control many aspects
of the compensation process, including claims handling, impairment or disability
evaluation, dispute settlement, benefit amount guidelines and cost-control strategies.
In addition to the compensation process, cost containment and claims management
continue to be significant employer concerns and many look to managed care vendors
and third party administrators for cost savings solutions. The Company believes
that cost drivers in workers’ compensation include: implementing effective
return to work and transitional duty programs, coordinating medical care, medical
cost management, recognizing fraud and abuse, and improving communications with
injured workers. CorVel provides solutions using a holistic approach to cost
containment and by looking at a complete savings solution. Often one of the
biggest cost drivers is not recognizing a complex claim at the onset of an injury
often resulting in claims being open longer and resulting in a delayed return
to work. CorVel uses an integrated claims model that controls claims costs by
advocating medical management at the onset of the injury to decrease administrative
costs and to shorten the length of the disability.
Some states have adopted legislation for managed care organizations (MCO) in
an effort to allow employers to control their worker’s compensation costs.
A managed care plan is organized to serve the medical needs of injured workers
in an efficient and cost-effective manner by managing the delivery of medical
services through appropriate health care professionals. CorVel is registered
wherever legislation mandates, where it is beneficial for the Company to obtain
a license, or where the MCO is an effective utilized mandate. Since MCO legislation
varies by state, CorVel’s state offerings vary as well. CorVel continually
evaluates new legislation to ensure it is in compliance and can offer services
to its customers and prospects.
The Company offers services in two general categories, network solutions and
patient management, to assist its customers in managing the increasing medical
costs of workers’ compensation, group health and auto insurance, and monitoring
the quality of care provided to claimants. CorVel reduces claims costs by advocating
medical management at the onset of an injury to decrease administrative costs
and to shorten the length of the disability. These solutions offer personalized
treatment programs that use precise treatment protocols to advocate timely,
quality care for injured workers.
PPOs are groups of hospitals, physicians and other healthcare providers that
offer services at pre-negotiated rates to employee groups. The Company believes
that PPO networks offer the employer an additional means of managing healthcare
costs by reducing the per-unit price of medical services provided to employees.
CorVel began offering a proprietary national PPO network in 1992 and today it
is comprised of over 750,000 board-certified providers. The Company provides
the convenience of a PPO Provider look-up mobile application for use with iPhone,
iPad and Android. The application is available to the public and makes it convenient
to locate a provider in the CorVel network. Users can search providers based
on quality, range of services and location.
CorVel has a long-term strategy of network development, providing comprehensive
networks to our customers and customization of networks to meet the specific
needs of our customers. The Company believes that the combination of its national
PPO strength and presence and the local PPO developers’ commitment and
community involvement enables CorVel to build, support and strengthen its PPO
in size, quality, depth of discount, and commitment to service.
The Company has a team of national, regional and local personnel supporting
the CorVel network. This team of PPO developers are responsible for local recruitment,
contract negotiations, credentialing and re-credentialing of providers, and
working with customers to develop customer specific provider networks. Each
bill review operation has provider relations support staff to address provider
grievances and other billing issues.
CorVel offers a unique approach to claims administration and patient management.
This integrated service model controls claims by advocating medical management
at the onset of the injury to decrease administrative costs and to shorten the
length of the disability. This automated solution offers a personalized treatment
program for each injured worker, using precise treatment protocols to meet the
changing needs of patients on a frequent basis. The Company offers these services
on a stand-alone basis or as an integrated component of its medical cost containment
services.
CorVel’s case management and utilization review services address all
aspects of disability management and recovery including utilization review (pre-certification,
concurrent review and discharge planning), early intervention, telephonic, field
and catastrophic case management as well as vocational rehabilitation.
The medical management components of CorVel’s program focus on medical
intervention, management and appropriateness. In these cases, the Company’s
case managers confer with the attending physician, other providers, the patient
and the patient’s family to identify the appropriate rehabilitative treatment
and most cost-effective healthcare alternatives. The program is designed to
offer the injured party prompt access to appropriate medical providers who will
provide quality cost-effective medical care. Case managers may coordinate the
services or care required and may arrange for special pricing of the required
services.
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