WorkCover Medical Advisory Panel tender Briefing. 4 October 2013



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Transcription:

WorkCover Medical Advisory Panel tender Briefing 4 October 2013

Agenda - Corporate objectives - Overview - Industry alignment and value added services - Service level standards - Health benefits of work - Criteria The application process and contractual arrangements - Overview of the specifications - Conditions of offer and the contract - Evaluation process - Key dates and considerations

WorkCover s objectives WorkCover aims to be: - Financially viable, balancing injured worker and employer needs - A customer focused insurer - An organisation of professional, engaged people WorkCover is fully funded by employer premiums and has maintained amongst the lowest premium rates compared to other schemes in Australia for many years. Our key focus is on a prompt and effective return to work for injured workers. We work with the injured worker, the employer, and medical and allied health providers to help rehabilitate the injured worker so they can return to work quickly and safely.

Working with WorkCover Industry alignment Our four regional centres are aligned by industry so we can develop expertise across the entire industry: Key industries manufacturing, construction, mining, retail, transport, labour hire, health and community care

Working with WorkCover Value added services currently provided by the MAP - Complex claim reviews and advice to WorkCover staff - Communication with treating doctors about treatment which may include surgery - Medical report reviews/evaluation - Peer to peer review discussions - Participating in educational forums/presentations - Designated Relationship Manager - Constructive feedback to improve in-house knowledge and training for our people

Working with WorkCover Service level standards - Acting consistently with our values - Working electronically - Advice must be provided within 24 hours of receipt of the referral - Telephone communication is preferred, however email is acceptable - Communicate in plain language - Maintain up to date account keeping systems that accurately records the time spent on claim referrals - Provide ongoing feedback about referral quality to WorkCover through the relationship manager

Health Benefits of Work and On Track Our scheme, which focuses on a stay at, or prompt return to work, and thus making work a crucial part of the rehabilitation process. WorkCover Queensland is a signatory to the consensus statement on the health benefits of work. Our Case Management is guided by our On track model - Early communication with injured worker, employer, TMO, TMS, AHP - Gathering information - RTW focus - Identifying aggravations/exacerbations early - Setting expectations and obligations with all parties

Overview MAP doctors can provide valuable medical comment in the following areas: - Reviewing surgery requests (including item codes) to ensure they are appropriate and required due to the work related condition or injury - Complex claim reviews and advice to our Customer Advisors to help develop rehabilitation and return to work strategies - Communication with treating doctors about surgery and treatment - Medical report reviews - Communicating feedback to other doctors as required

Areas of specialty Minimum of 10 years specialist experience, not including specialist training - Orthopaedic surgery (upper/lower limb, general, spine) - Neurosurgeons - Psychiatrists - Occupational physicians

Evaluation criteria - Involvement in a minimum of 8 hours per week of non-compensable, clinical work in area of expertise. - Recent experience (within last five years) providing independent medical opinion - Recent experience (within last five years) undertaking assessment of Permanent Impairment in accordance with AMA methodology - Provide confirmation that clinical practice is current/relevant and knowledge of current techniques and evidence - Provide details of two referees who can comment on your delivery of independent medical opinion - Current registration with the Medical Board of Australia (no restrictions) - Agree to comply with all SLS - Evidence of Professional Medical Indemnity Insurance

The application process and contractual arrangements Conditions of offer and the contract - Standard Government conditions apply link to terms and conditions included in ITO - Successful MAP contract of three years (with 2 x oneyear options)

Evaluation process Selection criteria - Experience 40% - Current clinical practice 25% - Capability 35%

Key dates and considerations - Use response forms strict compliance with response length and format - It is important to respond to all questions in response form 7.0 - Maximum of two pages per evaluation criteria - Resume to be sent as an attachment (3 page maximum) - Any queries to tenders@workcoverqld.com.au - All applications to be submitted online through Government e-tender site The anticipated timeframes are: Deadline for information/questions: 16 October 2013 Closure of Invitation: 23 October 2013 Commence evaluation process: 24 October 2013 Shortlisted Offers: 8 November 2013 New appointment commencement date: 25 November 2013