In this Rebroadcast episode, ADJUSTED welcomes Mollie Kallen, President and CEO of MKCM National Case Management. Mollie shares her insights about the differences between good case management and great case management!
Season 6 is brought to you by Berkley Industrial Comp. This episode is hosted by Greg Hamlin and guest co-host Paloma Duncan, Senior Catastrophic RESOLUTION specialist at Berkley Industrial Comp.
Visit the Berkley Industrial Comp blog for more!
Got questions? Send them to marketing@berkindcomp.com
For music inquiries, contact Cameron Runyan at camrunyan9@gmail.com
In this Rebroadcast episode, ADJUSTED welcomes Mollie Kallen, President and CEO of MKCM National Case Management. Mollie shares her insights about the differences between good case management and great case management!
Season 6 is brought to you by Berkley Industrial Comp. This episode is hosted by Greg Hamlin and guest co-host Paloma Duncan, Senior Catastrophic RESOLUTION specialist at Berkley Industrial Comp.
Visit the Berkley Industrial Comp blog for more!
Got questions? Send them to marketing@berkindcomp.com
For music inquiries, contact Cameron Runyan at camrunyan9@gmail.com
Hello everybody and welcome to adjusted. I am your host Greg Hanlon coming at you from beautiful Birmingham, Alabama, and Berkley industrial calm and I'm excited to share with you this rebroadcast where we talk about Nurse Case Management with my good friend Molly Kaelin one of the things that is so impactful for claims is having boots on the ground. And having done an adjuster, I can remember how much I relied on strong Nurse Case Management. And so in this episode, we spent some time exploring what that looks like what the role looks like, how that coordinates with the adjuster and what really makes for an effective Nurse Case Management Program. So I hope that you'll enjoy this one as much as I have. And again, just thank Molly for her time and spending it with me on this episode. Enjoy. Welcome everybody to adjusted a workers compensation claims podcast. I'm your host Greg Hamlin coming at you from beautiful Birmingham, Alabama and Berkeley industrial comp. And with me is my special co host for the day. Hello, Paloma Duncan.
Mollie Kallen:I will talk about my journey a little bit, but I'll just share with you now. So my company is MK cm, as Greg mentioned, and we're a national case manager coming over 500 case managers across the country. And I have a passion for what I do. I have a passion for a lot of different issues that are going on in our industry that we'll talk further about, and my backgrounds in education. So I love these kinds of formats and talking to people and also learning from others. So thanks so much for this opportunity, Greg?
Greg Hamlin:Well, we are certainly glad to have you. The topic for today is effective Nurse Case Management. And so that's one of the reasons we want to have Molly here and why I want to plomo to co host with me today because it's a huge piece of what we do in workers compensation in helping our injured workers return to work and get back to where they were prior to the injury. But Molly, the question I always like to start with is when did you know that workers compensation was going to be your colleague you jokingly said when I was five I knew. So I want to know the truth is that is that is that when the light bulb moment happened, you're like, Yes, this is my thing. Oh, yeah, no,
Mollie Kallen:totally not. And I was joking. So what I always tell people when I speak across the country is nobody graduates high school or college and says, I'm gonna go into workers comp, that is never usually the journey, the journey usually is very indirectly, you go into one area, and you're pulled into workers comp, from a variety of different areas. So same kind of thing for me. I didn't know what a case manager is, or was a lot of people still don't know what case managers are what we do. We were kind of like the unsung heroes, sometimes of this industry. When I was out there doing appointments, people would stop me and say, Are you a pharmaceutical? Rep. Are you an attorney? You know, I mean, nobody really understands this, and that's one of my beefs is that I think, really, in nursing school, and rehab, case management or rehab programs, we really need to be talking about alternative careers. Whenever I see nurses in the hospital outpatient, I've always talked to them and educating them, because I think a lot of people don't even know what this is. But just to kind of back it up. For me. My bachelor's was an elementary ed. So in another lifetime, I was an elementary school teacher, and I loved it. I was making $18,000 a year with a master's degree. And I was kind of like, you know, I love kids. But I can't survive this way. And what happened was, I got into counseling, my Master's in Counseling. I wanted to be a school psychologist, but then I realized that school psychologists are not really doing counseling, they're doing a lot of testing, which was not what I want. I want more clinical peace, right. So then what happened was I got a job in a psych practice doing counseling for injured workers. So that was kind of my first exposure to this population. And I really enjoyed that. And then I saw an ad in a paper and ironically as a case manager or I mean, as a vocational person, I always would tell people, you never get jobs through the paper, you know, it's always through talking to people, PS I kind of kind of started in this career from an ad in the paper. Right? Right. So I answered an ad in the paper from Infracore Inchicore. It was the very first case management company was owned by Cigna. And they were the very first ones to ever come up with this career and pay people. They were the first ones to use computers. I was rocking a car, Greg, blue Mercury Topaz that they go, Wow. And I thought I was like the bomb, I was driving through, you know, Ohio, where I'm from. And this car by gas was paid for. I'm like, this is a great gig. I love this. And I didn't even know what it was. And I just found my passion. I love talking to doctors, injured workers, adjusters and kind of being that middle person. So to answer your question, I fell into this position, which is like what a lot of people do in our industry, and I just really loved it. And everything just kind of grew. In fact, owning a company was not even in the plan. I had worked for all the big companies, I worked for Inchicore. Then I worked at core bow, and then Gen X. And then I started my company, it was never a grand design to like have a big case management company, people would offer me positions, ironically, to be a supervisor of case managers. And I was like, why would I do that case managers are just kind of strange people. You know, they they are just not the easiest people sometimes to do. So why would I want to supervise them PS again, here I am supervising 500 people. So life takes you and very strange twists and turns. But I'm just so happy that it took me here. It clearly wasn't a design at all.
Greg Hamlin:That's awesome. Well, I can totally relate to what you were saying about education, you know, and in that small check, you wanted to help people. You know, I, you said you love kids. I love kids. Obviously, we have six. But I started not for profit, too. So well. It was a little different than education, but not for profit fundraising. And I realized pretty quickly that that wasn't going to work if I wanted to have the amount of children that I have now. So here we are. But I think most people fall into this industry as well. Paloma, I assume that's the same for you.
Paloma Duncan:Yes, yes, it was for sure. It was that job fair. And same thing that you experienced at Indiana University where you were just walking around not knowing what you were going to do. And then there was Liberty Mutual and name? Yeah, I started.
Mollie Kallen:Yeah, I think it's something that is just so common in our industry. But I think we need to do a bit of a better job. Because especially now with what's going on with COVID. And everything, we have to really work at not just attracting the best people in our industry. But really retaining them is a big issue for me as well, too. We can talk more about it later.
Greg Hamlin:So for you, you talked a little bit about starting your own company, what motivated you to start your own company? That's obviously a huge risk. Scary Thing for lots of people, right? I'm sure it's also very rewarding in other ways. But talk to us a little bit about like, how did you decide that? Okay, I'm gonna do this.
Mollie Kallen:Yeah. And again, it wasn't kind of a design, it was just what happened was I after working for all the big three companies, I decided I kind of wanted to get on my own for a couple different reasons. I wanted to kind of bypass all that political layers, incentivizing case managers to Bill, you know, doing things all about billing, you know, I was so not about that. It's about really just providing a quality service, cutting out that middleman, and just really doing good work. So I was gonna go on my own, which I did, and I was out of my home office, just me, myself and I, and working. And then what would happen was is companies were like, well, yeah, we really like you. Is there another version of you in Ohio? Or is there another version of you in Texas? And what did I do, I would Google and connected and I grew a network, again, very organically, a network of case managers. And I decided that I wanted to differentiate my company from others. And the main differentiator is that I only use veteran case managers. So I went to people who were like myself, who have a minimum seven to 10 years of experience. And actually our average is 20 years and company, because I wanted people had a footprint. I feel that it really makes a difference. Listen, I was a green case manager. I made great mistakes. My favorite one was I complained to a doctor, people let me go for about 10 minutes about the office manager. Oh, she's horrible. She never returns my phone call. She never returns my emails. Oh, my God, man, like went on for 10 minutes. And who was she? His wife? Yeah, well. Insert foot, right. Yeah. So I mean, I've made all the green mistakes. And yes, and it's important. We all make mistakes. I still make mistakes. But I wanted people who were beyond that. I wanted people who know what they're doing. They have relationships because it's really all about who you know, in life in general. So that's how we get good results. We don't keep out so So again, it was kind of an organ And next thing, I started to amass this list of experienced case managers, and I just kind of grew. So again, it wasn't like a purposeful thing, it just kind of grew and grew. And, and I just love what I do, I love working with these case managers are very much a partner, you know, and I think they lose out in other companies too, because they usually have somebody who's supervising them who's never walked the walk or talk the talk. And I've been there, I've been in an office with a doctor who was grouchy and was just nasty, you know, I've been with a belligerent, you know, injured worker, so I get it, I get how hard our job is, it's really hard job. It's all about boundaries, you know, we get pulled in lots of different directions. So that fuels me every day and making a difference in people's lives. And I think we forget that, that we really do make a difference. People are at a very vulnerable point when we're working with them, right? I mean, they're dealing with injuries, they're dealing with their their lives, economic loss, pain, you know, not understanding the medical system, you know, not understanding what the doctor just said to them, you know, so our job is to really break all that down and educate them and really help them through. So it's been a real gratifying journey. That's for sure.
Greg Hamlin:That's awesome. So one of the things that I wanted to know a little bit more about was, you know, you've been doing this for a long time, you talked about the importance of experience and having experienced nurses, maybe for those who haven't had as much exposure to what a case manager or nurse case manager can do. Talk to us a little bit about what their role is, if you're having an onsite nurse case manager in a workers compensation injury?
Mollie Kallen:Yeah, absolutely. I do. One of my talks is case management one on one again, because a lot of people don't know, I have whole slide about what we can do what we can't do. And so the way I describe it initially, is remember those Venn diagrams we had in school, you know, we're I use the Venn diagrams to kind of describe all the different players on the team members, right? You've got gestures, you've got risk managers, you've got providers, you've got attorneys, you know, all those people. And then in the middle of the wheel, you've got the injured worker, they're the most crucial team member. And lots of times we lose sight of that, you know, it's so important that you have empathy that you have trust, that you have that education piece, so they feel empowered. So our job is a case manager, if you still visualize that circle that I was talking about, we are kind of like the person that intersects between all those different team members, between the injured worker, the doctor, you know, the providers, the physical therapists, the MRI, you know, all those people, the attorneys, everybody who's on that team, the risk manager, we are the connector, because many times you guys know, being in the business, the right hand is not the left hands doing. You see that a lot with the physicians, especially if it's multiple providers, you know, you got a physiatrist you gotta pay management, you got an ortho? Well, these doctors, it still boggles my mind, they don't communicate, they don't communicate on any level, they don't communicate on medication, they don't communicate on treatment, therapies, all that stuff, DME, you know, so our job is to make sure that everybody's aware of what's going on. And that the case is moving in a positive direction, that the injured worker is getting what they need, that they're, you know, getting the best care, that we're also trying to contain the client, not letting it bleed out unnecessarily to providers as a need to go to, for example, doctors tend to always, you know, refer out your your ortho, I tell them, you know, they want to cut you, but they don't want to cut you. And if I don't want to cut you, I'm gonna send you to pain management. Well, there might be other things to do, why go to these steps. So our job is case managers to present alternatives respectfully to the physicians, and to update everybody, all the stakeholders about what's going on, to help move the claim to a positive resolution. That's my definition.
Greg Hamlin:That's fantastic. So Paloma, I know you've had a lot of experience when it comes to handling difficult claims. Talk to us a little bit about how nurses have helped you and what you're doing on your more difficult claims.
Paloma Duncan:Sure. So it's always nice to have eyes and ears on somebody that you speak to you read the medical reports, but you don't really pick up on those nonverbal mannerisms and things that you might see. So that information is always crucial for us, when we're seeing somebody that's not recovering, maybe they are still smoking and they you know, record that they're not smoking, those simple things that they can pick up on that we can't we don't see them. That is crucial for us, along with kind of just getting that judgment feeling of you know, I have concerns that this, you know, maybe a malingering patient or you know, I'm really concerned with the treatment plan here. The doctors not looking at what I'm telling him is concerning maybe we need to redirect care. So those situations I feel are very helpful to have an an on site nurse attend the appointments and like you said, educate the patients and give them reassurance on what they're to be doing once they leave the doctor's office, right because a lot of times you The doctor just writes the note and doesn't maybe verbalize, you should not be doing this, that or the other. And this is what you need to do. But the instructions and language barriers, I'm bilingual in Spanish. And so I know you have a lot of bilingual nurses, that is amazing. You can see a huge impact on any file that has a bilingual nurse, because the communication barrier can be huge, not only language, education, culture, all of those things make a huge difference if you understand where they're coming from and what kind of guidance they might need. So
Mollie Kallen:I can piggyback to Greg I mean, everything a plumber said, I agree there's different types of case management for those of the people are listening might not be as sophisticated. No, there's telephonic case management, where we're just kind of coordinating everything on the case telephonically. And then there's field that Paloma mentioned, obviously, she's handling catastrophic cases, do case management usually starts very early on, we get a call. And what we're doing is like, as soon as we hang up the phone, we're calling the hospitals, either even their teeth of going into surgery, I'm very transparent, and how we operate our business. So we're all about cost containment and ROI for our customers. So if someone's going into surgery, right, pull them out, you're not going to want to stay out of the hospital, just hanging out in the hallway. Medical for you, right and get you information. By the way, we still get medicals, but 80% of the time, we still are able to get medicals on the phone still boggles my mind. But we do. And then we go out. And we're you know, that's where it's a really key role. And we take it very seriously because we represent the employer and the insurance company to a family who is dealing with a catastrophic situation. Understand the medical, they don't understand what's going to happen to their lives, their loved one is maybe they're on event or who knows and ICU. And we come in there physically to do a couple things, one to kind of review the medicals and send you guys over medical as we can to to kind of triage the case with the providers and see how long this is workers going to be there for diagnosis prognosis, are they going to rehab? Are they going home? Do we need dem ease and three, which is really key, which Paula mentioned was emotional support. Ya know, people care about you, you're in a system that you might not understand. Let us help you navigate through that system. And we're going to be with you through this process to make sure you get the best care and coordinate everything for you. And that's really, really important because that trust building that I talked about starts right then because these people are mistrusting, they don't understand what's going on. They're confused, they're afraid. And we got to come in there and kind of help that. So catastrophic case management, again, once we're out of the hospital, that's a really different kind of a skill. I always call it like the plate spinners. You know, you gotta Yeah, it's a catastrophic case manager. It's a whole different level than regular case manager, because you have got to be dealing with like 10 spinning plates at the same time, because you're dealing with vendors for tmes, and home modifications, and physiatrist orthopedist, and neurosurgeons and you're coordinating all that care, transportation, home health. So that's a whole different thing. But like you mentioned, for the few case management, eyes and ears, right, we see how the inter Walker walks in, we see how they walk out, we see when the doctor bends over, the doctor is rolling his eyes. That's really huge information. That's not going to be an email, you know, that's a
Greg Hamlin:it's not going to be in the medical report.
Mollie Kallen:Yeah, no way. I rolled my eyes when Johnny bent over Oh, my God, not this depo. Here we come, you know. But also looking at the job. You know, we'd love to get job descriptions and review those with the doctors and injured workers. That's key making each Yep. Well, I
Greg Hamlin:can't tell you how many times I've had an injured worker when I was an adjuster. They go to the doctor's appointment. If there's nobody there, they'd say, Well, is there modified duty? And that guy would say no, there's no modified duty. But there was right? No one ever was there to say, Well, wait a minute, what are his restrictions? And what can he do? And can we work with the employer and let me help coordinate that so that he's not just sitting on the sidelines? And I think that's a huge thing that nurses can do that adds so much value? Absolutely. The other thing I've seen is sometimes the doctors, they are so busy, they have so many things going on, they're going from thing to thing to thing. So Paloma might write the doctor a letter, but he might not look at it for a week. Oh, my God, no, do weeks, you know, and they might be really good questions or information we want him to discuss. But we don't have a way to have that dialogue. Because if we call we're not going to get them on the phone most of the time. There's a couple of doctors who will do that. But most do not. But sometimes the nurses can have those discussions.
Mollie Kallen:Yeah. And you just brought to a really good point that was going to read my mind. So one of the key things that we do as case managers and I think it's the most efficacious is Doctor conferences, one on one sitting across the table from a doctor with those questions that maybe Paloma had with the injured worker not being there. And we have the undivided attention of the doctor. And we could bring old medicals or whatever and sit across the table from him and have him respond and pay attention to what we're doing. And again, that experience comes into play. I'm an experienced case manager. I can pull Dr. Smith aside say Dr. Smith, really, don't you think it's about time then, you know, the Johnny kind of go back to work. So you can have those kinds of conversations informally, that really impact a case. But if you weren't experienced and had a relationship with that, doctor, there's no way that you could do that.
Greg Hamlin:That's an excellent point. So Paloma, maybe I want to ask you this and then have maybe Molly chime in, out of curiosity. So when you've had nurses on files, you've been doing this for 15 years plus something like that. So when you've had nurses on files, there's good ones, and there's great ones, what's the difference for you? When you say, Well, that was a good nurse? Or that nurse was amazing? What's the difference?
Paloma Duncan:Yeah, relationships are everything right? I feel like once you establish that relationship and trust with an injured worker, you see things move smoothly, and resolve and have a good result because they trust that you are guiding them in the right direction. So I think just establishing those good relationships early on, and communication are definitely two of the big things that I've noticed with nurse case managers, and then coming to me and making sure that what their plan is, is what I'm thinking as well. So that we work together and establish a goal that results in a return to work, you know, maximum improvement, those goals that we have, and in the timeframes that we're looking at. And if they're not there, then addressing the setbacks together, I think is very important for an amazing nurse case manager or, you know, having those conversations like Molly had mentioned with the doctor having those conferences, saying, you know, maybe we need to check some blood work or have some of this done that he's that healing, you know, aren't you concerned that there might be something else going on here? Those those things that they can pick up on and communicate with the doctor, effectively and with myself, I find to be very amazing nurse case managers that do that.
Mollie Kallen:I'll jump in. Yeah, go for it. You know, I'm shy. I'm writing notes furiously as well as talking. So being proactive versus reactive. II, anticipating things like me, as a case manager, I would call that adjuster and employer after document said, Hey, Dr. Smith's talking about pain management, if things don't get better, let's see what we can do about this. So looking ahead, thinking outside of the box, I had a case once were there keeping somebody in the hospital over the weekend for a knee Walker, because they couldn't find a knee Walker, what did I do? I googled one 800 Knee Walker found somebody got the knee Walker got him out again, thinking outside the box with the approval of the employer. Next thing we always do a lot in our company. I think we've lost the art of phone calling in our industry and a lot of industries. Emails are great. Gotta love. However, nothing makes me crazier, right? Because it's encrypted emails going back and forth about the same issue a, b, we everything's discoverable. So if there's something sensitive, it should not be in an email. So we're, we're big believers in round tabling cases, you know, we'll suggest it or a casserole suggested, hey, you know what, we think we need to get everybody on the call for five minutes, 10 minutes, and really kind of look at this case, come up with a plan, and then go forward. So that
Greg Hamlin:I love that Molly. And I say I just had one come across my desk this morning, where there was an ad, this is not on the nurse case manager side. But there was an agent and insured that had been sending emails back and forth with an adjuster. And then they felt like they weren't getting answers. And I finally just talked to the adjusters that, hey, we just need to make a phone call pick up the phone. Let's have a phone call here. Because I think this can all get sorted out in five minutes. If we just talk to each other 100% Do you think this is going to be a new challenge? I do think this isn't going away. Because I look at my kids and the most recent college hires, and they do this I can't people can't stop if you're just on their phones texting all the time. They do not call their friends they text their friends. Yeah. And so are they snap their friends or whatever the word, you know, whatever the the cool kids are doing now, but it's not it's not colleague. And so I remember when I onboard a new adjuster, it's probably been four or five years ago, they had sent three emails sent to faxes, and it had been a month and they hadn't gotten an answer. And I said, did you have you? Have you tried calling? And they're like, Well, no, it makes me insane. Yeah. But they're kind of petrified to pick up the phone. So that's something that I've had to work on with with some of them. And they come with different skill sets that are wonderful in other ways. But that is a spot that has changed. And I think you're right, especially when you're talking about doctors who may be in their 50s and 60s. They're not doing that. Yep.
Mollie Kallen:Well, I we task our case managers when they first get a case, not just to reach out to all the stakeholders by email, but they've got to do it by phone. And I hold them to that, you know, did you call Susie Did you call you know, because again, emails are great, but you know, maybe that adjuster found out a kernel of information on this injured worker that they don't want to put in writing, but it's important for us to know as case managers so Oh, totally agree with you. I totally agree. And then the other thing is I was gonna mention too is good media update. That's what I got distinguishes a good case here. Like look, you guys can all read doctor's notes. We can all read plenty notes. We do not need to regurgitate information for you guys, right? You want to know subjective objective barriers return to work, you know, MMI and we work really hard our company And we've come up with a template that we're starting to roll out about standardizing updates, because God bless all my case managers, they all write these long. I'm sure you've seen the right paragraph, and I look at them and already my eyes start to glaze over, like, Oh, God, how can I read this? Give me the meat, potatoes, you know what's going on? So we're constantly talking to our nurses, but they're in our case managers, but they're so used to charting and hospitals, right, and they can just write whatever and a lot of times, so we're trying to streamline that information. And then also responsiveness is key, like you said, communicating. If you guys ask a question, we give them 24 hours to answer they got an appointment, they have 24 hours to update. You know, if we treat telephonic just like field, I don't care if you're handling how telephonically they went to a doctor's appointment within 24 hours, you call that doctor, that injured worker you get as much as you can. So I have never understood how this should just be normal. You know, I mean, I don't understand there's a lot of companies out there that's like, oh, yeah, you know, a nurse didn't show up. What do you mean, a nurse didn't show up? You know,
Greg Hamlin:that's a huge deal. And it's yeah, it can be a huge deal if you're counting on it, if we're counting on it, because you know, we can't be there. So when you think about some of the challenges that you have in Nurse Case, management, obviously, there's probably some unique ones involved. I can think of a few. But I figure you have you have your list as well. I know that one challenge. I mean, this just comes to the top of my mind is epic. There's so many states and every state has their own rules on what you can and can't do. And I imagine that's something that you got to juggle on your end, what are some of the other things that you see?
Mollie Kallen:Yeah, and that's a challenge, because rulings and laws are always changing, you know, so we always try to stay on top of that, that's definitely challenging boundaries is an issue. It's very hard as a case manager, and I kind of alluded to it before, we feel like sometimes we're pushed and pulled in lots of different directions, octagon about that circle, all the different stakeholders, well, they might not all have the same goal, you know, the injured workers goal might be to stay out of work, but nobody else's goal is to get them back, or vice versa. Our job is to kind of do what's ethically correct for everybody, but also kind of like manage the claim. So we're getting good outcomes. So lots of times you feel you're being pushed and pulled and our case managers sometimes because they especially with the cat cases that Paloma handles, you get very connected to these injured workers and their families. So you have to walk a fine line and not become overly connected, that you have to maintain that objectivity. Because we at the end of the day, we're professionals, we have a job to do, and we can't be pushed and pulled by even the family members, you know, we want to do what's best. But you know, your family member might want a hot tub being built in their home. And that might not be medically necessary or right now financially efficacious for anybody to do. So you know, you have to kind of walk that fine line. And we're we're very careful about that. We're looking at emails, we're looking at reports. And you can kind of see when it starts to veer. And we that's when we kind of intercede again, being proactive versus reactive. If there's a problem, you just jump on it. And if we have to transfer file, we will we hate to do that. Sometimes it's the converse, sometimes the personalities don't get along at all, whether it's a case manager, an injured worker, the case manager, the doctor, case manager and the adjuster, you know, so we're dealing with people and I always tell customers and potential customers that we're going to make mistakes, we're human things are gonna happen, but we're going to own it and try to fix it and learn from it. So boundaries is a big deal. Like for example, like I said, They'll ask us sometimes to take video to doctors, we can't get involved in surveillance surveillance issues, we can't have an email, we can verbalize to a doctor, Hey, did you see that video that Paloma sent on my blog. But we can't get involved with that we have ethics that we have to maintain as case managers. We can't get involved in anything that's adjusting or surveillance wise, or any of that kind of stuff either, like, Hey, I didn't get my check paid. You know, help me with that. I'm always telling case managers, that's not our job, you need to start to the adjuster.
Greg Hamlin:Know, and those are fantastic points. I think, you know, there's a real move right now to claims advocacy, which I love the concept behind it. And we've kind of done our own twist on that calling an empathetic resolution model. And the main reason for that my big concern with the word advocacy is who are you advocating for? Right? There are a lot of people involved in this. There's the insured the actual employer who paid a premium to the carrier. There's, you know, the stakeholders of the carrier, there's the injured worker who needs the right treatment. There, you know, the list is really long of all the people involved. So if I'm advocating for the injured worker without thinking about how it connects to everything else, going back to your thing about boundaries, that's challenging. So trying to find that balance, I think is hard. woma Have you have you noticed that some in your experience on the claim side?
Paloma Duncan:Yes, yes, most definitely. And you know, there's a saying that, you know, a nurse, a nurse has heart so they have a lot of compassion. And so I can see how that can be challenging. So once you're meeting with these people regularly, they have multiple appointments throughout the week, then The wife is there you see their children like you develop a bond. But then again, you kind of have to step back. And remember, what am I here for what are you know, objectively, you can have that relationship with them, which I think is crucial for them to be able to trust. And you know, that is all, you know, empathetic. I'm all about that, I believe in that strongly. But then also, like Greg said, remind remember the stakeholders and everybody involved and what the big picture is, overall.
Mollie Kallen:Yeah, I talk a lot about social determinants of health. And I think it's and again, that's like echoing what Greg said, the movement in our industry right now is empathy, holistic approach to claims and to injured workers. I think that's really important, too. And when you do that, it definitely affects the bottom line. Oh, yeah. We all have to be aware of the bottom line, we get that. And I think, though, you know, we've lived in a world where we've kind of like been in pods in our industry, you know, you get the adjuster pod, you got the we're all a family. We're all right, as we all are a team and that injured worker cannot be forgotten. Everybody, you know, thinks, oh, they're malingering when the statistics 10% or less is really, you know, but that 10% takes up 90% of your time we get that. But you know, not everyone's a player, and most people aren't. And you're right, yeah, it's to look at the most Listen, as we were brought up as case managers, I've talked about this before, we were told, Don't ever ask questions about their family life, don't ever ask questions about how they're feeling. Stay out of all that somebody that is the way we were raised in industry. So a lot of your case managers they know to stay out of there, they don't want to go down that road, well, we need to go down that road, because that road, affects pain, affects recovery, affects return to work, you know, affects compliance, going to therapy, going to doctor's appointments. So we as case managers need to kind of open our view, and realize, you know, what, we have to help them find resources in their community that could help them What if they're having trouble with food, you know, in the house, or childcare, to enable them to go to therapy or a doctor's appointment? So we need to kind of open our horizon a little bit and realize that, you know, we really do need to kind of address those things. And it's not dangerous, doing those things, is dangerous, not doing those things. It's a whole different paradigm shift than what we've been taught before.
Greg Hamlin:Yeah, I think you're right, I think it's thinking about the big picture. And then communication, what you said earlier, communicate, communicate, communicate, we've got to be talking to come up with solutions will ultimately the best, the best result is they get healthy, they get back to work, and the employer has some back on their workforce, and everybody gets to move forward. But you know, if we don't address all the reasons and obstacles that could be there, and we might find ourselves right, fighting over something that in the end puts us in a much worse spot?
Mollie Kallen:Absolutely. Nobody, you know, you want to decrease legal, you want to decrease psych, you want to decrease pain management, you know, medications. So how do you do that? By keeping that connection with your injured worker and making them feel empowered? You know, people feel disenfranchised, that's when they're like, oh, you know, I don't really know, how many times do we hear from injured workers? I never hear from my employer. They don't care about me, you know, so that it's the littlest thing, right? That motivates somebody to be non compliant or to hire an attorney. And once you go down that slope, that's, it's very hard to relocate
Greg Hamlin:spectrum. Trust is hard to rebuild once you lose it. 100%. And that's kind of goes for all parts of life. I think. So. Yeah. So we've talked a little bit about empathy. And we've talked a lot about your company. I know you mentioned that. One of the big differences for your company opposed to some of the others that are out there is the seven to 10 years of experience, what do you feel like are some of the other differentiators when you decided I'm going to create my own company? I wanted to look like this because I think I have that with my team. Like, when I became a vice president of a Claims Department. Those were the things in my mind, like, what did I want this to look like? Why are we going to be different than our competitors? And how is that going to be something that's an advantage as we're competing in the marketplace?
Mollie Kallen:Yeah, three, three main things. So one of the experiences, we talked about having the footprint, that's huge. That's, to me, the key differentiator enabled us to you know, not keep files open as long and by the way, we don't incentivize case managers develop, like in the companies I was brought up, you know, do what you do. And I'm when I'm onboarding customers, I tell them right away, okay, I don't care where are you from, but this is the way it rolls here. So the experience makes a big difference number one, number two, is our QA our quality assurance. So I have a department made up of all experienced case managers or adjusters, you know, people in the industry, and every case manager is assigned one counselor, and this QA counselor, and we're copied on every email, and we read it or whole QA team is on that, you know, email. So we're reading the email. So we have a company calendar, it's voluminous ly detailed and nobody does this because it's so detail oriented. We track every milestone of every case, doctor's appointment, Mr. If ce que me all that stuff. up, and we're tracking when you guys ask a question, you need to make sure that answers in 24 hours, we're tracking after a doctor's appointment, you know, all this stuff is being tracked, to give us all that quality and our case managers, even though their experience, that's the level I expect them to be at, you know, if they get a question and you don't respond, you get a case, you need to respond within 24 hours, you got an appointment, and you respond within 24 hours. So our QA, I've never seen a company that does it. Usually, again, we're proactive versus reactive. The only time I see other companies and I experienced this, get involved is after the problems happened. And by then you're playing catch up, you know, in life, in general, when you're behind the eight ball, you're not going to do as well as when you're 48. Alright, so the QA is huge. And then the third difference, I think, is our transparency. Like I said, we're going to take ownership, we don't pass the buck, If a mistake is made, and it's our mistake, we're going to eat time or whatever, and then learn from it, I do my due diligence, I know there's five sides to every story. Because I have a story of the case manager to you know, the injured worker says this, The doctor says this, he just said, you know, I My job is to kind of drill down and see what I really feel is real, and then to learn from it and to take ownership. So, again, that transparency travels to other issues like referrals, you know, I turned down referrals, which is unheard of in this industry, right? Why would you ever turn down a referral, you know, because if I don't have the best case manager to handle it, I'm not gonna just throw a body on a firewall, you're not gonna get good ROI. And I care about my customers and my customers respect that. You know, I,
Greg Hamlin:I appreciate them all. Because you've done that to us before where we called you on something and you said, Why could but the travel time just doesn't make sense. It wouldn't make sense. And I think you can find somebody closer who can do the right thing for you. And I really appreciated that instead of you just saying, Well, I can solve your problem. And then we get a bill for, you know, three hours or two hours of travel time. That doesn't make sense. Yeah. No, I don't believe
Mollie Kallen:in that. Yeah. I mean, I think that, again, being honest, and treating people like the way you want to be treated, you know, I mean, honesty is always the best policy, I always tell that to my team, I tell it to my case managers, you know, if something happened, you know, document it and confess off to it, you don't want to hide. So I really am happy to hear that, Greg, because you know, and lots of times, I'll offer, Hey, can I eat some of the travel time and the mileage? If I feel I have a good case manager who knows the doctor who could do a good job for you? And if that's the only stumbling block, then I'll help out. But I'm always honest, you know, and I'm very proud of my team that the same way, because that's how our customers trust us. We talked about trust. That's huge right here. I mean, a trust with customers.
Greg Hamlin:And absolutely, yes. So what's your favorite part, Molly, of being in this business?
Mollie Kallen:It depends on days. I feel like I wear a firefighter hat. And I'm putting out I'm sure you guys feel this way too, right? Yes, fires all day long. Usually, it's a full moon. I can't do the correlation. There's a full moon and everybody's blacking out. Yeah. But what I really love is making a difference in people's lives, no matter how small or large. And I was at a partners meeting with a customer of ours and a guy who was involved in a catastrophic case, surprise me, it was there and talked about what a difference case management meant in his life. He was unconscious, and his wife was dealing with the case manager. And he was talking about what a difference it made in his recovery. And I was starting to cry, because I didn't, you know, again, we do our job. And you know, we're used to doing our job, we kind of forget, but we really do make a difference, we really do impact people. So that's the most rewarding. Another thing that's rewarding to me is when you have somebody being discharged from the hospital, they got injured in one place, and they live in another. And I love it. I call it like a symphony when it works, because we have one case manager who's working with the hospital and another case manager where they live. And then the case managers are talking to each other. So that way, when that injured worker comes home, they're not waiting two weeks for an appointment of a robot. So I love that kind of synergy that happens, you know, when you've got multiple case managers working a file together and helping each other. I just really enjoy what I do. No, no, two days are the same. Right? You know, and the day flies by and then it's like three o'clock, like, oh my god, what happened? But no, I really enjoyed I love working with the case managers, because I know what their job is and how hard it can be, especially when COVID happened. You know, I always tell my caseworkers to do not do anything that you're not comfortable with. Don't put yourself in the situation, we rolled out telehealth that was great, you know, to have as a tool in our toolbox. So I really respect our case managers are on the front lines, they do the hard job, you know, my job is nothing compared to what they do. So I love all aspects. I think of the business and the vocational case management, all that other kinds of stuff and do life care plans. You know, it's kind of need to see like the whole I stay in my lane. You know, people come to me and said, Hey, do DMEM do transportation? Yeah, that's what I do. stay in my lane and do a good job.
Greg Hamlin:Oh, that's fantastic. I couldn't agree more with you, Molly, my, I was interviewing a candidate yesterday for a position in our company. And he was asking me like, what, what keeps me going? He asked me that same question. And I said the same thing. It's people, it's a feeling like I can make a difference. Yeah. Either the injured workers that we work with, or the staff who worked for me, I felt like there's opportunities to hopefully some people's lives are better, because what I'm doing all day long, and that's the goal anyway, and so I can completely relate to that. I want to throw you both a curveball here to end it out. So one of the things I feel like and maybe it's just always been this way, but it seems like there's a lot of yelling and shouting at each other and anger back and forth when you turn on the TV of who's right, who's wrong. And it's created an environment that sometimes it feels like, the only things going on are really negative. And I really believe there's beautiful things going on. And so one of the things I decided to do this season is I wanted people that we interviewed to share a memory of a time that they were truly happy. What were they doing and what Who were you with, and it doesn't have to be work related. But I just want to show people who are listening to human side of everybody, because I think we get so caught up in the negativity. And I really believe that there's beauty out there if we just take time to acknowledge it. So maybe I'll throw it to Paloma first and then have Molly jump in and share her her memory.
Unknown:Sure, sure. So
Paloma Duncan:me and my family, we love to travel. And I would have to say within the past year, we've resorted to traveling to a lot of national parks. And one of the happiest days was when we were at Zion National Park. And me and my boys and my husband climbed Angel's Landing out of the way to the top. But I was proud of how far we made it. And just the journey up there. You know, I have a 11 year old, an eight year old and they're troopers. But you still heard the complaining, you know, hey, well, how much longer was it? You know, I'm thirsty, do you have some Twizzlers? You know, all those things. But then, you know, on the way, we also met very interesting people that we, you know, made relationships with and connected with. And once we got to where we were, you know, they look down, and they're like, Wow, we made it this far. And they didn't think that they could do it. And I think that was in itself rewarding. It's obviously a beautiful park and in a peaceful, you know, situation in itself. So I think overall, that just kind of made my heart very happy to see that we were all together in you know, nature and with the children, and they were able to do it. And they thought they couldn't do it. And we all accomplish something together. And I think that was rewarding considering everything that we went through with COVID. And, you know, online schooling and all of that. It was just something we all did together, and everyone was happy in the end after it was somewhat of a struggle to get up there.
Greg Hamlin:I love that forum. I bet designs is beautiful. So if you haven't been people should go check that out because it is definitely one of those inspiring places. But I think my favorite thing about what you shared is that your joy came through seeing others and your family push and do something they didn't know that they could do, which I think just says a lot about who you are promo. So thanks for sharing that. Molly, what's yours?
Mollie Kallen:Oh, I have to convince you to Yeah. It's so hard to narrow it down. So we're close. I'm gonna travel. It's like, oh, yeah, I have one day when I love England, I think in a previous lifetime if you believe in this stuff. Because I'm walking around London, and people stop and ask me for directions. I feel really comfortable there. I feel like I've been there before. I just adore London. And we finally have our trip. My family. My husband and my son have never been abroad. So I'm taking them we were supposed to go two years ago and then COVID and everything happens. So we're going Hey, so I'm very excited. But it's very different to go travel like you mentioned and you guys both know the kids and going by yourself. Yeah, you know, so this is a whole different trip. But anyway, my favorite time is I was in Hyde Park. I love staying in the Kensington area when I'm there. And I was in Hyde Park on my birthday just walking through the park by myself and just really liking Wow, I'm in London. I'm in my favorite place in the world. I'm here on my birthday. You know, it's peaceful. It's relaxing. I'm looking around all the people and just very grateful. You know, I agree with Paloma traveling, I think it's the best education. If more of us travel there'd be less prejudice. More appreciation for our lives in United States. I'm telling you, I love travel. But gosh, we have a really good here compared to other countries. So and travel is just key. So that's my first one I love, you know, being in England and stuff. And the second one is we were in Charlotte over this past Thanksgiving and again, travels have taken a whole new meaning guys, right since we weren't able to do it. I think we're savoring it more now because we didn't have the opportunity to do it. Greg will never have the opportunity to travel. So many kids, but anyway, but we were in Charlotte, you rented a lake house and my son had never seen like fall leaves like he's a Florida guy and we live in South Florida. Oh yeah. It was hysterical to watch. He raked a pile of leaves. And I said just jump in. And he's like, Well What do you mean? Mom? You know, he goes, Do I fall back? Do I sit? Do I lean into it? I mean, there's like a whole big discussion about because I grew up north, I'm like, do you just jump in God and I jumped in, and it was just so nice to see. And you live through your kids, right? You lived through their eyes. And for him to kind of experience Paul, and he never experienced it before. It was just really kind of cool. So that was really a happy moment too.
Greg Hamlin:I love that. I love both those thoughts. I I think for me, I can really relate to your discussion that your your your memory in Hyde Park and that for me, I think some of the best moments I've had are those quiet moments where you're really pondering and you just you can feel at peace and you'll like can see where things are clear for a minute and yes, and not so busy and obviously with with six kids. There's there's lots of leaf jumping and craziness that happens. I could write a book on crazy Hamlin stories for sure. They're great. Well, Molly, I've so enjoyed having you with us today. I seem for you Paloma. It's a joy to work with both of you in different capacities and want to thank all our listeners for joining us for this episode, and would remind you to do right think differently and don't forget to care. That's it guys. Hope you join us next time.