We draw upon the best resources to control claims from the onset, emphasizing a healthy return to work.
Matrix integrates all disability programs—insured or self-insured, statutory and voluntary, short-term and long-term—to achieve seamless service to you and your ill or injured employees regardless of the duration of their disability.
To better facilitate an employee' s recovery and timely return to work, these programs can also be integrated with our Workers' Compensation management program and Family Medical Leave and LOA programs. In addition, we can integrate Salary Continuance with STD, Statutory Disability and LTD. For the state of CA and NJ, we can integrate with Paid Family Leave.
In those states that permit private plans and where self-insurance is desirable and feasible, we will provide guidance to the client regarding the implementation of a self-insured plan, including the preparation of employee communication, state application forms and regular reports for that state.
In those states that do not permit private plans, we will ensure that short-term plans that supplement statutory benefits are properly integrated to prevent overpayments. We administer self-insured plans in California, New York and New Jersey and can administer fully-insured plans in New York and New Jersey through 1stRSL and RSL respectively.
Matrix simplifies the administration of complex, fragmented and overlapping disability plans. We provide all the instructions and information needed to eliminate confusion and reduce hassle in an easy-to-understand format and in compliance with governmental requirements. We ensure accurate, timely benefit payments.
We believe the human touch reduces anxiety and establishes a rapport with the absent employee, helping facilitate an earlier return to work. Your employees will always have a designated claims examiner who is knowledgeable about your employees claim.
Our automated duration review system is an integral part of claims management at Matrix. Utilizing nationally recognized guidelines, this system provides us with a statistically valid data base on which to make claim management decisions as well as benchmark our client's duration experience. Further, it establishes a method to identify claims that require internal claims management intervention and medical case management.
Durations are based not only on diagnosis, but also the employee's age, gender, concurrent medical conditions, job functions and the treatment regimen and/or procedures being utilized by the medical provider. (For information on return-to-work services, please refer to the Nurse Case Management.)
We keep recovery on track. We flag claims that fall outside of the parameters that we establish with you. Your claims team maintains contact with attending physicians and reviews each claim for extensions of disability. If necessary, we engage independent medical consultants to ensure that your ill or injured employee's recovery is progressing to a healthy Return-To-Work.
Our proprietary cross-reference system, identifies all other claims filed by the claimant with any Matrix client. This process targets fraud, as well as supports quality medical care by providing information on previous illnesses/injuries that could affect the patient's current condition