Medical Consulting and Case Management

Our mission is to provide compassionate and timely care to return the claimant to full duty and MMI as quickly as possible. As third-party providers, we objectively assess the condition and treatment of the claimant with the goal of return to gainful employment at the highest possible level of functionality. The value of a case manager is having an objective medical professional communicating on all levels to ensure participation of all parties and the timely update of information regarding patient care and status. We can save time and reduce cost for each participant in the claims process while ensuring appropriate and timely treatment and return to work for the patient. What does a case manager do? The Medical Case Manager (also known as a Medical Consultant) can be placed on a file by the employer or insurer for the purpose of medical care coordination. Medical care coordination consists of maintaining contact with all parties involved in the claim to include the patient, adjuster, employer, providers, and attorneys if assigned. It is the responsibility of the case manager to schedule and attend physician appointments, and schedule any therapies, diagnostic testing, and/or procedures. The case manager will meet with patients and providers to obtain information and documentation regarding the diagnosed injury, treatment plan, and work status. These visits can be done telephonically if/when the circumstances require it. Contact is maintained with the carrier to ensure information, regarding work status and provider visits, is up to date in order for the adjuster to make timely and accurate payment of benefits and medical bills. Contact is maintained with the claimant (or their attorney) to ensure the patient is aware of and attends appointments and treatments, as well as ensure the patient understands the treatment plan, work status, and expected outcomes. Contact is maintained with the medical providers via telephone and onsite visits to obtain updates on diagnoses, medical care causality, treatment plan, work status, and anticipated MMI/PIR. Contact is maintained with the employer to ensure changes in the work status, including restrictions as set by the physician, are communicated allowing the employer to provide work that the patient can reasonably perform within said restrictions. Contact will be maintained with attorneys, claimant and defense, if assigned to the claim. If the claimant and/or their attorney cuts direct contact with the case manager, the case manager will continue to meet with the providers in order to coordinate the care of the patient. The case manager will update all parties as usual