The BacktoBetter process

Transcription

1 The BacktoBetter process

2 What is BacktoBetter? BacktoBetter is the clinical case management service that members use when making a claim for any musculoskeletal symptoms (such as back, neck, muscle or joint pain). This guide walks you through the steps that you should follow when using BacktoBetter. Remember, you don t need to see your GP before starting a BacktoBetter claim. The first step? Call the helpline If you experience a musculoskeletal (MSK) symptom (for example back, neck, muscle or joint pain), the first thing you should do is contact the customer service helpline - you don t need to see your GP. This means your claim can be assessed and you can start to benefit from the BacktoBetter service. You ll need to provide a brief description of the symptoms you have and Aviva will let you know right away if the claim is eligible. If so, you ll be offered a telephone clinical assessment with Nuffield Health. If you call before 4pm you ll usually receive this the same day (or if it s after 4pm, you ll receive one within 24 hours). Call the customer service helpline number which can be found in your member documentation What happens next? The comprehensive telephone assessment enables the clinical case manager at Nuffield Health to help recognise the nature of your symptoms, the impact they re having on your daily activities and the most appropriate form of treatment. This may be one or more of the following: Take a look at the following pages to see what these entail.

3 A Self-management What self-management entails If you have mild symptoms, self-management is likely to be the best course of action. This means that you can look after yourself with a home exercise programme and advice from a clinical case manager. Nuffield Health will check up on your progress after an agreed timeframe (dependent on your symptoms). They will close the case once you feel your symptoms have improved and you ve achieved, or are in the process of achieving, your goals. If you still experience symptoms after self-management, the case manager may consider a referral for either physiotherapy or specialist intervention.

4 B Face-to-face physiotherapy What face-to-face physiotherapy entails step 1 If, following the telephone clinical assessment, face-to-face physiotherapy is recommended, you ll be authorised for an initial assessment and a follow up treatment session. These sessions will usually begin within 48 hours of the telephone assessment, or at a time convenient for you. All treating physiotherapists must be registered with the Nuffield Health network. This is the first step of physiotherapy and the second is featured on the next page.

5 B Face-to-face physiotherapy What face-to-face physiotherapy entails step 2 The treating physiotherapist will submit an initial assessment report to Nuffield Health within 24 hours of your first session. The report will outline the proposed treatment programme and the goals to be achieved. Further sessions may then be authorised depending on the recommendations made. The third stage of physiotherapy is featured on the next page.

6 B Face-to-face physiotherapy What face-to-face physiotherapy entails step 3 If your symptoms resolve following the recommended treatment programme, the treating physiotherapist will submit a discharge report to Nuffield Health, explaining the reason for discharge and any self-management advice you ve been given. If you don t respond to physiotherapy, you may be referred for specialist intervention.

7 C Specialist intervention What specialist intervention entails Following your telephone clinical assessment, you may need specialist intervention to treat your symptoms. If your condition is serious enough to require this, you can be referred directly to a specialist. Nuffield Health can liaise with Aviva to identify a suitably qualified and experienced specialist, as well as providing cover for appropriate diagnostic scans. If surgery is required, Nuffield Health can arrange any pre or post-operative physiotherapy that s required. Once again, this can only be provided by a physiotherapist registered with the Nuffield network. Nuffield Health will continue to supervise your treatment until such time as you ve recovered from your symptoms or the condition itself becomes chronic, when cover for ongoing treatment will not be available under BacktoBetter. In this scenario, Nuffield Health will recommend that you speak with your specialist to discuss NHS care before closing the case. For further information, please call the customer service helpline number which can be found in your member documentation

8 Aviva Health UK Limited. Registered in England Number Registered Office: 8 Surrey Street, Norwich, NR1 3NG. Authorised and regulated by the Financial Conduct Authority. Firm Reference Number A wholly owned subsidiary of Aviva Insurance Limited. This insurance is underwritten by Aviva Insurance Limited. Registered in Scotland, No Registered Office: Pitheavlis, Perth, PH2 0NH. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Firm reference number Aviva Health UK Limited Head Office: Chilworth House, Hampshire Corporate Park, Templars Way, Eastleigh, Hampshire, SO53 3RY. aviva.co.uk/health Aviva PLC GEN5846 REG001 09/2018