Medical Case Management Solutions

Blood Bourne Pathogen Protocol

The Injured Worker is proactively guided and monitored through the prophylactic process, enabling early identification and treatment of potential infection; often resulting in significant cost savings, as well.

Expert

Nurse Case Managers utilize sound professional judgement to formulate opinions and make recommendations expressed via report, deposition and/or testimony.

Family and Medical Leave Act (FMLA)

A Registered Nurse clarifies and authenticates FMLA certification by obtaining precise and accurate medical documentation through contact with the Employee's health care provider (with Employee's consent).

Liability Reviews

A medical record review to assess if an injury was caused by the accident and, therefore, determine the responsible party for treatment and associated costs.

Long-Term Medical Care Projections

Medicare Set-Aside Allocation
A Medicare Set-Aside Specialist identifies the amount of settlement dollars to be "set-aside" for future injury-related medical expenses for a "qualified" individual. Comprehensive services range from assisting in determining need through CMS approval.

Case Cost Assessment / Medical Cost Projection (primarily non-litigated cases) / Life Care Plan (includes a narrative for litigated cases)
A comprehensive assessment of both the current and long-term medical/therapeutic needs of an individual who has incurred an injury, illness or disease, based upon recommendations of that individual's health care providers, with associated expenses; assists in establishing reserves and/or determining settlement dollars, in non-litigated cases.

Pain Management and Narcotic Review

A Program designed for cases with extensive narcotic use and duration generally, in which more than one narcotic has been prescribed for more than six months. The use of opioids to treat acute pain can be safe and effective, however, misuse and abuse raises concern for serious additional health risks, increased medical expenses and the potential for litigation. The focus is communication with all case parties, with the goal of agreement, and even, treatment for weaning.

Telephonic Medical Case Management (TCM)

An appropriate and cost effective service for less complicated and less severe diagnoses/injuries; cases are managed telephonically, with opportunity for smooth transition to full field case management or field task assignment.

Translation

We have enhanced our interpretation capabilities to now include multiple languages in order to better serve a diverse community of injured workers.

Trauma Response

Crisis Intervention
A Team of Medical and Vocational Case Managers coordinate and conduct a supportive group meeting during a period of extreme or potentially extreme distress, designed to mitigate the impact of exposure to crises/trauma and enhance coping abilities.

Systematic Desensitization
The Case Manager conducts a series of meetings with the individual who has been involved in a traumatic event to generally include a return to the site of the event, equalizing the impact, with the goal of enhancing a successful return to work activities.

Triage

An early intervention program in which a specially trained Nurse provides 24/7 immediate medical and educational self-care consultative services to Employees.