Case management resources

SAIF's claims teams and nurse consultants

We assign a return-to-work consultant and claims adjuster to each injury claim. The claims team also has a staff of experienced nurse consultants who assist adjusters and work with medical providers. Ask the claim adjuster to have one work with you.

Managed care organizations (MCOs)

When a claim is filed with us, the employee is notified in writing that she will be subject to MCO requirements. SAIF works with four MCOs:

• Caremark
• Kaiser On-the-Job
• Oregon Health Systems
• Providence Health Systems

Prescription drugs

Oregon Prescription Drug Program (OPDP)
Note: This program will be effective March 4, 2008.
Beginning in March 2008, SAIF Corporation will use the Oregon Prescription Drug Program (OPDP) to administer pharmacy benefits for the approximately 45,000 injured workers that SAIF serves each year. Injured workers will not have to pay out of their own pocket for prescriptions related to their workplace injury. Most major and local pharmacies participate in the program.

To learn more about how OPDP can help you and your family, visit the State of Oregon OPDP website.

First Fill
Beginning March 4, 2008, injured workers will be eligible for the First Fill pharmacy program, which provides a limited number of cost-effective prescription drugs for work-related injuries or illnesses until a decision has been made on their claim.

Pharmacy bills will be handled through the Oregon Prescription Drug Program (OPDP) and paid by SAIF, even if the claim is later denied. There will be no out-of-pocket costs to the injured worker or to the policyholder for the prescriptions, unless a medication not covered by First Fill is prescribed.

• View the First Fill prescription drug list.
• Locate a pharmacy in your area.

Smart drug choices
Drug prices can vary significantly and price does not necessarily correlate with efficacy. Results from an ongoing Oregon State University study give prescribers important information on drug effectiveness. Learn more about this topic. 

 

Wellpartner mail order pharmacy

Workers can save time, travel, and hassle by having their regular, ongoing prescription medications delivered to their homes for no extra charge by using Wellpartner. Non-work-related prescriptions can be added to orders for work-related prescriptions, but the worker will be responsible for payment of those items. Prescriptions are delivered in seven to 10 business days.

To order using Wellpartner:

• Workers can register by calling Wellpartner at 800.417.8806 or signing up at www.wellpartner.com.
• Workers can fill out an order form and mail it to Wellpartner with their original prescription(s). Download the form
• Doctors can call in prescription(s) to Wellpartner at 866.935.5797, or fax them to 866.624.5797.
  
  

Returning to work

Once you have succeeded in helping an injured worker recover to the point of returning to work, you need to:

• Complete a work release form. You can use the Release to Return to Work form provided by the Workers' Compensation Division - form 440-3245 (PDF or Word) or use your facility's equivalent work release form, if it has one. You may need to complete this form multiple times during treatment as abilities are added.
• Complete either of these documents if the employer sends them to you: a request for work release information, or a written job description of transitional or regular work that may be available to the worker. Return these to the sender as soon as possible.

If you have a question or need assistance, please don't hesitate to call us at 800.285.8525 or email your question to providerquestions@saif.com.