At the Daily Allowance Centre, all reported cases of incapacity to work are reviewed and the potential return to work is examined in detail and prioritised appropriately. During this process, our focus is on managing our insured persons. In addition to medical investigations, direct and personal assistance often yields excellent results.
Initial contact with the doctor certifying the incapacity to work is key to accurately assessing the potential for management. Medical considerations are vital for an accurate prognosis.
We distinguish between good, unclear and poor prognoses. Depending on the instructions provided by the attending physician, the claim is processed in a different manner. For good and poor prognoses, our focus is on ensuring that daily allowances are paid out in good time, while unclear prognoses require closer examination to determine the next steps.
When the prognosis is unclear, medical and paramedical specialists determine whether it is appropriate to involve case managers or whether further medical investigations are needed.
Case management is the most effective and best support measure for all employees insured with Visana. After speaking with the employer and obtaining their permission to get in touch, our case manager contacts the person who is ill, explains the process and recommends the next steps.
If the insured person decides to have an initial consultation with a Visana case manager, a meeting or a phone call is arranged. The aim of the initial consultation is to outline the relevant medical, professional, family and financial aspects, so that preliminary options for action can be agreed right away.
By planning a course of action, discussing objectives and consulting the attending physician or, if necessary, other social insurance partners such as the invalidity insurance scheme, the person is gradually reintegrated into their current employment or into a new position.
Involving our case managers offers four clear management benefits for employers and employees:
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With the support of case management, new prospects for the future can be quickly developed.
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Our case managers coordinate the support of all relevant parties (doctors, family members, employers, social insurance providers).
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The discussions with the doctors are very helpful and valuable.
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With a forward-looking approach, the valuable work of our case managers helps to support and motivate our insured persons.
If the management operates as intended, the average duration of all Visana claims is reduced, which benefits all our business customers, either by ensuring premiums remain attractive or by reducing the follow-up costs that longer absences generate for the company.
To ensure that case management works effectively, Visana brings together professionals from a variety of backgrounds – specialists with medical training, case managers, legal experts and specialists in operational case management – who work hand in hand. They all contribute their expertise to find the best possible solution for companies and their employees.