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Nurse Case Management Services


Our pro-active case management is provided by experienced RNs who are proven professional problem solvers! Our nurses minimize out-of-work time and maximize cost savings by acting as advocate, advisor and medical care manager. We also facilitate the flow of information to/from the claimant, claims professional, treating physician, and ancillary healthcare providers as we help the claimant negotiate through the recovery phase of his injury. We will, as necessary, arrange authorizations, procure DME, and expedite step-downs in facility care. All of this is aimed at getting the patient to back to work in light-duty or full capacity and achievement of MMI in the least amount of time.

Spanish speaking Nurse Case Management -

For your Spanish speaking patients


Our Nurse Case Manager will facilitate a better outcome by speaking with the injured party in their native Spanish dialect. She will assure a better understanding of diagnosis, treatment, process and expectations. Use of our Spanish speaking Nurse Case Management Service has been proven to enhance patient compliance, minimize patient apprehension and assure optimal medical outcome.

Early Intervention

 

It is widely known that early medical management is absolutely essential to achieve the best possible outcome. Our nurses begin working the file immediately. Our nurses will make the initial 4 contacts within 24 hours of receipt of the file and will telephonically work the claim for 30 days under this program. This can be the perfect solution for minimizing outlays on non-serious injuries because it prevents the case from "drifting" and becoming a much bigger case. We are often able to help the claimant RTW during this period. Our EI program is a flat fee service for cases 30 days or less from DOI.

Telephonic Nurse Case Management

 

Telephonic Nurse Case Management is a cost effective tool in the medical management of the recovery of an injured worker. Our nurse will pro-actively manage the claimant through the recovery phase of his injury via telephone saving the costs associated with on-site case management.

Because the claim is managed pro-actively we can often facilitate an early, safe RTW.

 

On-site Nurse Case Management

 

For difficult, complicated and Catastrophic injury cases we offer highly trained and long experienced on-site RNs. Our nurses are available for hospital and home visits as well as to accompany claimant on treating physician office visits. On-site Nurse Case Management can be of great assistance to identify the current status of the claimant and to identify/anticipate the future needs. Face to face visits with the clamant and his care givers can give a valuable perspective and can often mean the difference in assisting the claimant through his recovery. Our on-site nurse can also facilitate obtaining medical records on the newly injured worker with serious/complicated medical problems.

On-site (limited) Nurse Task Assignment

 

A one time on-site visit to assist the claims professional get a glimpse of the status of the claimant and his condition. Our On-site nurse will provide you with a report based on the specific objectives as directed by the claims professional. Often a single task can provide the insight necessary to manage an otherwise difficult case. Works well in conjunction with telephonic Nurse Case Management.

Alternitive Dispute Resolution

 

Nurse Case Management specifically designed to enhance Alternative Dispute Resolution "ADR" programs which were established jointly by employers who are signatory to an appropriate Union collective bargaining agreement and their employee's Union locals. These files are handled by veteran Nurse Case Managers familiar with the nuances of this highly successful program.

Nurse File Review

 

When Nurse Case Management is not needed the claims professional might need medical assistance with the claim. A file review by one of our seasoned professional nurse case managers will provide insight as to the medical direction of the case. Our long tenured RNs will perform a one time review of the documents presented with no direct interaction with the claimant.

Staff Enhancement

 

Consider us to fill temporary gaps in in-house staffing.  We would be delighted to assist with your overflow and/or as a temporary fill-in for unexpected absences of in-house staff.  Just give a quick call and let us know what you need.  We’d be delighted to step up to the plate for you!

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