Worker's Compensation

Our field case managers serve as an intricate part of the medical case management strategy for worker’s compensation. Combining new technology & extensive field experience our case managers facilitate the continuum of care between the injured workers, providers, treatment protocols and employers to ensure the best possible outcome for all!

Case management is a collaborative process of assessment, planning and advocacy. To create options and services to meet the injured worker’s medical needs through communication and available resources to promote quality cost-effective outcomes.

The Case manager is, in a sense, an extension of the worker’s compensation adjuster, but performs any or all of the following functions:

Assess the medical aspects of the injury or trauma that gave rise to claim.
Corresponds with treating physicians and coordinates referrals to specialists as needed.
Ensures that the treatment plan and return to work status are effectively communicated in a timely basis to the employer, adjuster and ancillary providers.
Provides input to rehab plan and coordinates accordingly.
Evaluates and monitors the injured worker’s progress and compliance in rehab. Recommends the appropriateness and types of post-acute care to achieve the best possible outcome for the injured worker by the most cost effective means.
Acts as a liaison between injured worker, medical provider, the employer, ancillary providers, and the adjuster as to medical and rehabilitation issues.
The case manager ensures the medical provider knows what factors can impact rehabilitation and injured worker’s return to work status.

List of services associated with WC:

  • Field Case Management
  • Telephonic Case Management
  • Utilization Management
    • Pre-Certifications
    • Peer Reviews
      • Concurrent
      • Retrospective
  • IME Coordination
  • Task Assignments
  • Vocational Case Management
  • Medical Cost Projections
  • Medical Records Analysis
  • Wage Loss Analysis
  • Hospital Desk Audit