MedInsights' Telephonic Case Management (TCM) services provide medical management services and direction by registered nurses from the onset of the treatment process.
The emphasis is on ensuring "best practice" medical treatment for the work injury and an early, safe return to work.
Our telephonic case management services:
- Provide early assessment within 24 - 48 hours of notification;
- Utilize customer specific criteria, usually based on high risk, high dollar injuries;
- Perform an initial four-point contact with 48 hours of receipt of referral;
- Utilize evidence-based, nationally recognized guidelines and evaluates the care plan for medical necessity of treatment;
- Ensure compliance with state managed care organization regulations;
- Evaluate ADA compliance;
- Establish return-to-work (RTW) targets using Official Disability Guidelines (ODG);
- Promote ongoing coordination between the employee, provider, employer, and claim adjuster;
- Facilitate an ongoing "interactive"" process between all parties;
- Assist in developing modified and transitional return-to-work programs and evaluating progress toward targets;
- Coordinate all ancillary services to deliver optimal, safe return-to-work and recovery.
To request more information, please contact us.