PTPN CompDirect

With PTPN CompDirect, you get complete transparency and accountability not only for Physical Medicine costs, but also for clinical quality and outcomes. Physical Medicine can make or break an injured employee's return to work, so PTPN's unparalleled commitment to clinical excellence significantly improves outcomes and lowers overall costs.

 

PTPN is a Physical Medicine utilization management pioneer, as the first specialty network to develop a UM Program more than 20 years ago. Working in conjunction with your UR staff or your outside UR company, our program does much more than just ensure compliance with standard workers' compensation treatment guidelines, such as MTUS, ODG, and ACOEM: It also gives you the benefit of our three decades of Physical Medicine experience to achieve the best possible balance between care effectiveness and cost efficiency.

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What truly sets PTPN CompDirect apart clinically is our innovative approach to managing providers based on treatment outcomes and other quality measures.

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​​​Our top-tier providers, who earn priority status for patient referrals, participate in the PTPN Outcomes Program:

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• The PTPN Outcomes Program is a proprietary system that uses technology to

  • track injured workers' functional improvement during treatment,

  • measure treatment outcomes, and

  • monitor provider efficiency.

• ​​It compares patient improvement and provider performance to national benchmarks, using the nation’s largest and most validated database of rehab data.

• It predicts the expected amount of improvement and number of visits.

• It focuses on individual patient needs by incorporating scientifically validated risk adjustment factors, like age, gender, and severity.

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In addition, our top-tier providers must pass PTPN’s strict Credentialing Program, which is the only Physical Medicine Credentialing Program that includes on-site credentialing and re-credentialing visits. PTPN’s program requirements exceed other networks’ and state licensing requirements, and surpass those that such accrediting bodies as the NCQA (National Commission for Quality Assurance) require for physicians. Metrics include staff-to-patient ratios, office cleanliness, equipment calibration, HIPAA and OSHA compliance, patient safety, and more.

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Our top-tier providers also participate in the PTPN Quality Assurance Program, which reviews medical records to ensure provider compliance.

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​All of these quality measures are compiled into PTPN’s proprietary provider report card, the PTPN ROI (Rehab Outcomes Index), which gives you a snapshot of the quality and performance of PTPN therapy offices. Our proprietary evaluation system incorporates several measures into a detailed report card – the first of its kind in the Physical Medicine industry.

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Having these high performing top-tier providers as the core of your Physical Medicine network means better treatment outcomes, which means lower total cost of claim (including reduced downstream medical costs, such as radiology, pharmacy and surgery costs) and faster return to work.