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Medical Case Management Services

Special Intervention Assignment | Medical Only Case Management | Occupational Case Management

Approximately 80 percent of IMO cases are closed within 120 days of referral.

Special Intervention Assignment

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Definition
A 30-day solution that integrates resources and action plans either as a specific or limited assignment.

IMO case managers review medical records then communicate with the employer, the injured employee and the medical providers to accurately evaluate the association between the employee's health, the medical treatment and the return-to-work plan. One visit is made with either the physician, client or injured employee, allowing the case manager to be consultative and impact the case in the most timely manner. The employer is provided with a medical and occupational overview, documenting case status and prognosis of the employee's return-to-work expectations.

When you need it
Worker's compensation and group health cases when:

  • There is uncertain medical status
  • Second opinions are needed
  • Early intervention is key to facilitating timely case closures

How it helps
Prevents a case from escalating, thereby reducing medical expenditures, and returning injured employees back to work sooner. Case Study: Special Intervention Assignment

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Medical Only Case Management

Definition
An objective assessment for medical direction.

IMO's specialized case managers review medical files and reports and provide you with a specific evaluation of the injured employee's medical status, healthcare and prognosis.

When you need it

  • If the injured employee has been terminated;
  • litigation is imminent and there is no contact with the employee;
  • the employer needs a second opinion, medical records or an assessment of maximum medical improvement status;
  • medical treatment has not been rendered; or
  • medical treatment is questioned.

How it helps
Determines when it is appropriate to close a case, and keeps employers "in the know" and involved in managing their healthcare costs.

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Occupational Case Management

Definition
A bridge between the occupational and medical elements of an injury that focuses on the abilities of the injured employee while addressing continued medical needs.

Unlike traditional case management, Occupational Case Management includes the employer as part of the rehabilitation team. Working partnerships between the employer, employee, medical providers and claim representatives develop creative return to work plans that bring employees back to work in an appropriate time frame and in a cost effective manner. IMO oversees all outside medical intervention.

When you need it
When an employer is unsure how to reasonably accommodate an employee with physical restrictions or a specific work release, or an employee is losing time at work or is back on a limited duty.

How it helps
Prevents duplication and over utilization of medical services; capitalizes on the available productivity, and ability of the injured worker; and optimizes the use of available resources, minimizing unnecessary spending. Case Study: Occupational Case Management

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Click here for a printable PDF of Medical Case Management services.

 



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