Medical Case Management

Medical Case Management

A Case Manager is responsible for all aspects of service delivery to physically and/or mentally impaired clients. Case managers communicate with the injured employee, and the medical team to assess, plan, implement, coordinate, monitor and evaluate medical management needs and services. The goal of medical case management is to assist the injured worker in attaining an MMI, (as complete a recovery as possible) and returning to work.

It is important that the Medical Case Manager is familiar with Medicare Set-Aside issues!

Medical Appointments are often attended by the medical case manager with the patient and immediate feedback is received regarding the status of the medical condition. The medical recommendations are obtained and reviewed with the employer/carrier to prompt handling. The medical status and office notes are faxed to the employer/carrier immediately.

The Medical Recommendations and status are reviewed with the injured worker, to assure his understanding of complying with medical advice.

The medical case manager will obtain the date of maximum medical improvement, obtain the PPI rating and determine if the client has any permanent work restrictions. The case manager will maintain contact with all members of the team to assure that the patient, physician, and employer/carrier are well informed of the case status.