An informative weekly series for the benefit of those managing claims of injuryLast week, we talked about medical case management as a collaborative process. This issue will talk about how a case manager begins by familiarizing themselves with the case. The methods most widely used include:
- Discussion with the claims manager about the course of the claim
- Review of medical documentation
- Chatting with the claimant (if possible)
- Conversation with health care providers
After the review process is complete, the case manager is ready to evaluate medical aspects of the claim
(such as the appropriateness of treatment, relationship of care to work injury, and return to work issues). Following that, cost issues such as what it will take to close the claim and/or return the injured worker to work as quickly as possible need to be considered.After these assessments have been made, the case manager is ready to develop and implement a custom-designed plan of care that takes all issues of the claim into consideration and works toward closing the claim. Next week, we will learn the importance of staying on course.For more information visit our website at
www.MedicalSystemsUSA.com