Services

Medical Case Management

Telephonic or Field: We manage the medical aspects of any claim either in the field or telephonically. Referrals can be done as a limited task or full case management assignment. Our experienced case managers work in the best interest of all parties involved providing driven, cost effective results reducing case management and claim expenses. Our objective is to coordinate with the injured or ill party, their attorney, the attending physician and employer to assure their medical needs are met and to get the injured or ill individual back to work as soon as medically feasible.

Medical Task Assignments

Nurse Case Manager in Home Assessments. This is a non-confrontational, pro-active, informational task assignment to offer a better understanding of the claim status and ease any concerns you may have with respect to the activities of the ill or injured individual.
Claim savvy nurses are sent to visit the injured or ill person in their home environment. We will meet with them to assess their home environment and the medical aspects of the claim in an effort to determine if their medical needs are being met. Also, we will observe the individual to watch for obvious signs of disability, monitor their surroundings, report on their daily activities, point out red flags and make recommendations. Nurses yield greater results, create less suspicion and make the injured or ill individual more at ease with the process as compared to contracting an outside party that may have little or no medical background.

Medical Field Task Assignments. A one shot assignment sending a nurse to attend a doctor’s appointment, arrange for medical services or do an in home visit. We can provide additional information on any situational factor related to the claim.

Copy Service: When a request is made to have a claim file copied by an attorney or other party – CALL US! We will copy the file and bill the requesting party directly.

Vocational Rehabilitation:

We can assist injured or ill individuals with their occupational and vocational needs when they are unable to return to their former employment. We offer a pro-active, non-adversarial approach to job placement and work force re-entry. However, this product can be tailored to be more assertive with more difficult cases. We can also do task assignments such as a transferable skills analysis or labor market surveys.

Radiology Reviews:
We offer a second opinion on an MRI, CT scan or X-ray to either confirm or challenge prior findings. Our radiologists can also compare multiple scans taken at different times to assist with the determination of causal relationship of the present condition as well as attempt to identify pre-existing conditions.

File and Record Reviews:
Designed to provide a detailed assessment of the medical and non-medical status of the claim. Gives a perspective of where the file was, where it is presently and where it is heading.

File reviews can mitigate exposure by breaking down complex medical issues and putting them into perspective. Used as a negotiating tool for settlements when mitigating factors are identified. Our consultants will point out red flags and provide recommendations for further handling to reduce exposure.

Medical Cost Projections:
Provides pricing for specific treatment, surgeries, durable medical equipment and other related medical expenses for a given period of time.

The goal of a cost projection is to identify what the projected medical expenses are expected to be for a specified period of time. They can help mitigate exposure when considering settlements or assist with setting reserves. This assignment can be done at any time post injury and MMI does not need to be achieved.

Life Care Plans:
Designed to provide a comprehensive outline of the current and future medical, vocational, and psychosocial needs of a catastrophically ill or injured individual. This is performed by one of our certified life care planners. The claimant needs to be at MMI before a life care plan is done.

A life care plan will project the total medical costs for the balance of the individual’s lifetime as well as identify current and future medical needs. This task assignment can be used for settlement negotiation or financial planning in higher exposure cases as well as setting lifetime reserves. Our LCP’s can also critique a previously completed life care plan arranged by the individual’s attorney.

Independent Medical Exams:
Please watch our site for news on this exciting new service!