Case Management

WellComp’s proactive case management services help improve recovery and get injured workers back on the job faster.


 

Because not all claims require the same level of intervention, WellComp offers customized case management services to match the specific needs of each client – from early assessment to case closure. WellComp’s case managers work closely with the injured worker and treating physician to select the best medical options, and expedite all services to reduce costs – ultimately setting the stage for a positive outcome.

Our early intervention services are key to preventing injured employees from forming a disability mindset and help control claim costs. Nurse case managers can also coordinate
integrated services to streamline the managed care process, such as pharmacy benefits and durable medical equipment.

COMPREHENSIVE CASE MANAGEMENT SERVICES
WellComp’s cost-effective, results oriented medical and vocational case management includes:

  • Experienced case managers with extensive education in vocational injury management
  • Compliance with nationally recognized evidence-based treatment and return-to-work guidelines
  • Early intervention to help prevent the injured employee from forming a disability mindset
  • Expedited medical treatment through WellComp’s own preferred provider organization (PPO) and diagnostic imaging and scheduling networks
  • On-staff review physicians available to consult with case managers and direct discussions with treating physicians
  • Claim adjuster access to medical and vocational experts
  • Prompt communications with the employer, injured worker and physician
  • Treatment plan and guideline reviews with claim adjusters
  • Allows for more accurate reserve setting
  • Helps adjusters set specific red flags to trigger additional cost management steps
  • Peer-to-peer conversations between WellComp’s medical director and unresponsive and/or uncooperative health care providers

THE RIGHT APPROACH FOR EACH CASE
Telephonic case management is the most cost effective means of providing ongoing medical care coordination to facilitate a patient’s recovery and to avoid over utilization of treatment. Acting as an additional medical resource, the telephonic case manager works closely with the patient and treating physician to ensure that the best medical options are utilized.

Some claims benefit from face-to-face medical or vocational management, and can help expedite recovery on the more complicated cases that need more intense case  management. Our field case managers have extensive education and experience to ensure consistent, high-quality face-to-face services for injured employees. WellComp’s field case management services provide direct contact with the patient, medical providers and employer as needed. 

EASING THE RETURN-TO-WORK PROCESS
Our proactive return-to-work approach keeps the injured worker and medical providers working toward returning the employee to pre-injury status. When the employee is ready to return to work, our case managers can assist employers with developing successful return-to-work programs by:

  • Educating department leaders and supervisors regarding the program
  • Working closely with injured workers throughout the process
  • Assisting with job description updates
  • Helping to develop limited duty task lists that can be used to create suitable alternate positions for injured workers.

ONLINE ACCESS TO INFORMATION
WellComp’s web-based case management system can provides access to the telephonic case manager notes and correspondence as well as key documents associated in a case. This allows employers and adjusters faster access to information for faster claim resolution.