Why Case Management?

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UNDERSTANDING THE NEED FOR CASE MANAGEMENT

The Fist step to ensuring quality care

Case management is designed to assist injured claimants and their families effectively navigate the medical and insurance maze with an emphasis on individualized treatment and rehabilitation while maintaining appropriate costs.

All too often, claimants and their families have a bad experience with their insurance company and end up choosing inappropriate and/or elect costly rehabilitation and treatment simply because it’s the first and/or only option presented. This doesn’t mean all insurance companies are bad. Rather, it illustrates the importance of effective case management services that exist to help coordinate the right services to reduce anxiety, improve decision-making and secure appropriate treatment options while containing costs.

The Cornerstones of effective case &
elder care management

Counseling and Referral Options

Referrals to appropriate treating doctors, professionals, and service providers. A good number of injured claimants and families are confounded and immobilized by the overwhelming array of referrals and options. Case planning, implementation and control will focus on cost-effective options.

Documentation

Assistance with form completion, record keeping and records retrieval. Records management and control of medical issues.

Assistance Beyond the Scope of First Party Interest

e.g. Social Security problems, Department of Social Services issues, community resource networking, socialization, substance abuse counseling, life care planning, community reentry issues are addressed to reduce the overall medical, social, vocational and financial impact of injury. The use of these resources often shift costs from insurance companies to these resources.

Life Care Planning

The long-term view, which will focus on problem resolution, cost containment, reserve and settlement planning.

Catastrophic Injury Case Management

A new way to look at benefits for the injured claimants and their families. PIP - No-Fault-Auto - Workers Compensation, Third Party Liability, Elder Care Management and Pediatrics.

Educational, Vocational and Pre-Vocational Assistance

Coordination and cost containment of job related and return to work services and resources.

Cost Containment

Focus on negotiation for the best prices for services, long term versus short-term issues, budgeting, coordination of financial resources. Often there are other funding resources for assistance that are not the responsibility of the insurance company, e.g. Federal and State funding, such as, Medicare, Medicaid, MRS, Job Service, etc., split funding, as well as, private resources through grants, scholarships, and donations.