Exceeding Expectations … We Are All Consumers


A long-held belief exists that “the customer is always right” and whether or not you believe this to be accurate, we can likely agree that always being aware of the customer experience holds true. With increased expectations for simple and worry-free service with every interaction, we need to strive towards providing a seamless case management experience to injured workers, providers, employers, and claims management staff.

Exceeding customer expectations by providing the highest level of customer service contributes to a competitive edge and business growth. In the workers’ compensation industry, the case manager acts as the hub of a complex claim. Typically, they know the doctors and other treating providers. They know the employer. They are familiar with the patient’s medical file, and they often know the patient’s family and the non-medical factors that could affect progress. Case managers have clinical knowledge, claim-specific knowledge, and credibility. Increasingly, their professional knowledge and training encompasses not only the medical, but also behavioral factors that can help bring about change. Seasoned case managers follow these best practice guidelines when interacting with customers:

  • Promote collaborative and frequent communication
  • Consult with or seek advice to achieve clarification and feedback
  • Obtain and incorporate input from others
  • Communicate across cultures, and according to linguistic and learning needs
  • Build trust through education and knowledge
  • Educate and engage the injured worker

Cognitive Behavioral Therapy (CBT) techniques can also be critical to establishing an advocacy modelopen relationship and helping to overcome an injured workers’ non-medical, psychosocial barriers to return-to-work. They use these techniques to get to know the individual as a whole person instead of simply focusing on the injury. At Coventry we’ve seen a 14% improvement in return-to-work when using CBT techniques.

A best practice case management model is also focused on advocacy and delivered by a talented and knowledgeable team. It’s the quality of the direct customer contact that results in loyalty and successful relationships. Technological enhancements for immediate updates and response can also help stakeholders deal with uncertainty and any perception of a loss of control. It is the role of the case manager to address actual or potential problems to ensure the best possible outcomes.

Courtesy of Coventry's The Sounding Board

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