PHYSICAL THERAPY COORDINATION SERVICES

All parties to a claim (employees, employers, physicians & payors) continue to set the highest standards for coverage, service & results that we strive to exceed.

Service Offerings

Physical Therapy Coordination Services

Patients and payers benefit from job-specific functional treatment and assessment mandates that set us apart.

Assisting injured workers through recovery and effectively back to work is the mission of physical therapy efforts. Our processes for assignments, scheduling and routine claim coordination are designed to minimize the burden on busy adjusters, case managers and physicians.

Clinical oversight monitors, assesses, and ensures the delivery of medically necessary physical therapy care. Our clinical experts view each patient as a unique assignment. The entire care team utilizes evidence-based treatment guidelines, claim expertise and ongoing proactive communication to assure success.

Patient education reduces no-shows/walkouts and improves overall patient satisfaction. Written, voicemail and text appointment reminders, along with detailed pre-appointment educational materials, help assure a patient-centric care experience.

"Empowering patients through education enhances their understanding and commitment, leading to more effective and sustainable physical therapy outcomes. Knowledge fosters active participation, turning treatment plans into successful recovery journeys."

Make A Referral

Our friendly scheduling team is standing by to help coordinate physical therapy and FCE testing. To make a referral, call, fax, or click here to use our online referral form. 

An FCE Is Useful When:

  • Clarification on an employee’s capacity to perform certain physical activities related to occupational duties & capacity to work is needed.
  • There is a discrepancy between the subjective complaints and other objective clinical or non-clinical factors.
  • Objective data is needed to determine Permanent Partial Disability (PPD) per American Medical Association’s Permanent Impairment Evaluation guidelines.
  • An individual’s recovery progress requires measurement for vocational planning, alternate job placement or future rehabilitation decisions.

Types of Services

ON-SITE PHYSICAL THERAPY

Developed from real-life experience with return-to-work outcomes, our guidelines and protocols help clarify and govern the efficient review, approval and payment of physical therapy claims.

Our overall goal through physical therapy referral is to:

  • Match each patient with the best possible clinician by expertise, history of success and location.
  • Assure prompt scheduling of requested medical care
  • Progress the patient to Return-to-Work (RTW) status or Maximum Medical Improvement (MMI) through excellent medical care, solid communication & clear recovery goals.
  • Promptly document and release physical therapy recommendations, progress notes, “no show”/cancellations/reschedules, and discharges.

Monitoring treatment can curtail workers’ comp costs. Physical therapy care is a top medical expense category in the early stages of a workers’ compensation claim. Through the use of utilization management strategies to help physical therapists perform only necessary treatments, DefinedPT Network providers have a proven track record of delivering quality, cost-effective care.

FCE

DIAGNOSTIC TESTING

Coordinated by prescription through the Authorized Treating Physician and/or an Independent Medical Evaluation (IME) Provider, Functional Capacity Evaluations can offer objective documentation of a patient’s physical capacity to perform work duties. Defined PT Network providers specialize in work capacity evaluation.

WHAT IS AN FCE?

The Functional Capacity Evaluation (FCE) is a comprehensive series of performance-based tests designed to objectively measure physical abilities. The testing protocol gauges physical strength, range of motion, stamina, and tolerance of functional activities, such as pushing, pulling, lifting, and carrying.

This diagnostic testing helps determine work restrictions (if any) and options for return to work.

Note: Network FCE providers do not provide clinical physical therapy treatment to their test subjects. FCE testing is administered by an independent, objective clinician that is not involved in clinical patient care.

FCE components include:

  • Musculoskeletal Evaluation (strength, posture, flexibility, gait, sensation & reflexes)
  • Validity of Effort (includes a battery of 15 to 25 objective, research-based tests)
  • Cardiovascular/Endurance Testing
  • Functional/Work Tolerance Testing
  • Functional Mobility Testing
  • Body Mechanics Assessment
  • Patient Traits & Behaviors Observation

DISABILITY FCE TESTING ADDRESSES WORK CAPACITY ISSUES

The Defined RTW FCE was designed and accredited with the claims process in mind. Like other industry acceptable FCE protocols, this NIOSH & APTA evidenced-based solution provides diagnostic results that objectively measure patient physical abilities and report the findings. In addition, with a mobile component and real-time processing, this specific protocol adapts readily to solve coverage challenges in rural or remote areas.

Does a specific patient, employer or client program come to mind? The availability of PT providers equipped and trained to administer the Defined RTW FCE protocol is growing daily.

INCONSISTENT AND/OR SUB-MAXIMAL INJURED WORKER PARTICIPATION

Optimum injury recovery is achieved when patients put forth a best effort. Patients that are unnecessarily guarding or declining to put forth full effort are a common challenge facing clinicians and claims professionals alike.

The Defined PT Network providers and administrative team recognize that the workplace injury environment can introduce a complex maze of conflicting motivators. When inconsistency of effort or sub-maximal participation is encountered, extra care is taken to effectively communicate relevant details so that appropriate medical and claim support can be coordinated.