Medical Case Management

Our field case managers accompany injured workers to physicians appointments. We proactively discuss plan of care and return to work projections, follow up with workers to ensure they are getting the care they need, arrange for modified or alternate duty with employers, and report all activity to appropriate parties to promote a clear understanding of goals, progress, and claims resolution.

Catastrophic Case Management

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.