Catastrophic injuries require quick response by the nurse case manager as well as frequent collaboration with the adjuster, employer, attorneys, ancillary providers, hospital staff, and family members. Frequency of onsite visits vary and are determined by the nurse case manager in collaboration with the adjuster, based on the medical condition of the injured worker and discussion with providers, family members, and others involved in the client’s care.
Coordination of IMEs
A case manager will coordinate and schedule an independent medical exam (IME) with an appropriate healthcare provider. Contact with the healthcare provider, injured worker, employer, and insurance carrier will define and confirm requested information to be addressed by the healthcare provider. Upon approval from the injured worker and/or the injured worker’s attorney, the case manager will attend the IME appointment and report results to appropriate parties.
Peer Review
Carolina Case Management will arrange to have a specialized healthcare provider review medical records and diagnostic studies to determine appropriateness of care or proposed plan of treatment. A full report will follow the evaluation.
Task Assignments
Designed to assist employers and insurance carriers when full case management services are not deemed necessary. Task assignments can be a good choice for obtaining specific information for the referring party. Such assignments may include an initial interview, medical assessment, one-time appointment coverage, etc.