Question: What is Case Management in the Workers' Compensation Environment?
Answer: Case Managers work in many different environments, e.g., hospitals, out-patient clinics, as health insurance case managers and in the workers' compensation environment. The duties and responsibilities vary as to which environment the case manager is providing services.
The CompAlliance medical case management team works to achieve positive medical outcomes, minimize litigation and increase employee productivity. The CompAlliance medical case management team utilizes a four-point communication method involving the injured worker, physician, employer and claims handler; keeping all parties informed of treatment plans and current status. Early intervention results in early and timely treatment and facilitates informed decision-making. These URAC accredited services include telephonic or field and full or task assignments.
The Field Case Manager works in-person with the injured worker and all stakeholders to assure quality medical care is received and return to work is successful, resulting in decreased claim costs. The CompAlliance telephonic case manager performs strategic management of the claim telephonically, with the same goals in mind. Use of a telephonic case manager can be a very cost-effective method particularly for less severe injuries and when the injured worker has an excellent relationship with the employer and may be already back to work in a modified duty capacity.
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