Conexia

Workers’ compensation is the oldest social benefit program in the United States – most systems having already passed the century mark. The “Grand Bargain” is now a complex environment of conflicting incentives, causing frustration for employers, injured workers, and service providers alike. Adding to that complication is the differing perspectives of businesses – is workers’ compensation an employee benefit managed by human capital management (HCM) professionals, a risk to the business managed by a dedicated risk manager, or some combination of the two? For small to medium size employers who do not have the resources to manage their workers’ compensation risk internally, there is reliance on an insurance company, whose decisions affect everyone in the workers’ compensation claims management environment. Whether insured or self-insured, however, how a business manages its workers’ compensation claims is central to whether the best outcomes are to be achieved when a valued employee is injured on the job.

Workers’ compensation today, however, is an antagonistic, paper-based and all too often impersonal system, generating unnecessary delays and extracting what should be an unacceptable cost in terms of real and human capital. In order to change this all too often repeated picture, employers and their insurance company partners need to innovate. This is where Conexia comes in.

“The first encounter a worker has with workers’ compensation is almost always after they are hurt,” notes Conexia CEO Luis Navas. “If we can make that first encounter a positive one for the employer, the injured worker, and the medical professional treating that person, then we have the opportunity to improve outcomes.

Conexia assists organizations with their workers’ compensation model facilitating timely return-to-work and improved health outcomes while reducing the administrative and medical costs

The question then becomes, how we manage the change necessary to create this compassionate, cost-effective system? Conexia has the answer.” With two-decades of experience innovating the delivery of care, Conexia offers a comprehensive service model that initiates multi-stakeholder communications through online transactions, allowing real-time interoperable point-of-care communications. Our SaaS system accelerates the treatment authorization, claim management, and payment to provider processes while assuring that the best evidence-based treatment, often as set forth in state-adopted guidelines, is approved in real time. Conexia’s shared goal with our clients is to eliminate the use of paper and fax processes, reduce utilization review costs (and disputes), and improve injured worker return-to-work outcomes, by delivering an online interoperable ecosystem. Our experience working with network providers to manage this change completes the value proposition Conexia delivers for our clients.

According to Karen Conger, CEO of Occupational Health Link, a provider-owned managed care organization (MCO) operating in Ohio’s workers’ compensation system, “Conexia’s staff prioritized our requirements accordingly. After implementing the model, there has been an increase in the return to work rates along with efficiency and a decrease in the temporary total disability time taken, which is something you want to see in workers compensation.”

As insurance rating organization A.M. Best recently stated, “AM Best expects the output of the innovation process—those new or significantly improved products, process, services, or business models—to have a measurable impact.” Conexia delivers on the promise of innovation – in real time.