Frequently Asked Questions (FAQs) about Medical Case Management
"When should a case be referred to Case Management?"
Cases are usually referred for Case Management when an injured worker is non-compliant in attending appointments, is upset with his/her employer, or the case is not progressing. Other indicators may be:
- Clarification of the diagnosis and treatment plan
- Case is open more than 60 days
- A catastrophic injury has occurred
- Injured worker is not responding to conservative treatment protocols
- Injuries to back, knee or shoulders
- Injured worker has chronic pain or psychological issues that are interfering with his/her progress
- Case is lost-time
- Medication management is needed
- Coordination of Independent Medical Evaluation
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"What solutions are recommended in Catastrophic Cases?"
Chapman & Associates specializes in Catastrophic Case Management. When life and or limb threatening injuries occur, it is important to assign a Case Manager immediately to assist the injured worker and the family. Our Case Managers will follow the case from the emergency treatment, to hospitalization, to home. We take an active role in coordinating the physical, occupational therapy, rehabilitation. Home modification and durable medical equipment may be needed at home including wheel chairs, walkers, bathroom chairs, ramps, oxygen, etc. Our services may also include coordination of transportation to and from doctor's and therapy appointments.
"What is Life Care Planning and Medicare Set-aside Cost Projections?"
Chapman & Associates is experienced in developing Medicare Set-aside Cost Projections for clients who are approaching final settlement of Workers' Compensation Cases. A Registered Nurse will review the medical records, claims history and long-term treatment needs to develop a comprehensive, plan-based cost projection as required by Medicare.
The plan is dynamic in that the reserves change dependent on the health status of an injured worker who has had a catastrophic injury or chronic healthcare needs. Chapman & Associates professional team have advanced knowledge of disabilities and treatment care resources. Our team obtains the baseline information, reviews records, assesses the problems, researches treatment options and consults with physicians and healthcare providers. A preliminary plan is developed with associated items, costs, frequency and rationale projecting the annual costs for life. These finalized plans are then submitted to the appropriate parties for review and approval dependent on the client.
TESTIMONIALS
“You are awesome. Thanks for handling this situation for me." KD – ReviewMed
“Mindy has helped me navigate the Workers’ Compensation system and assisted me through a most challenging time. You are appreciated so much.” LP – Jefferson County Employee
“You are all wonderful. You assisted me with my frustrations and helped me with the appointments. Thanks so much.” BC, Injured Worker
"I recently encountered the most difficult claimant I had seen in my twenty years of adjusting experience. The only case manager that came to mind was Mindy Chapman. She has handled some of our toughest, most catastrophic claims and has done an incredible job with all of them. Mindy was able to get my tough, extremely non-compliant claimant into surgery, including extensive pre-operative testing and get him well on his way to recovery. What a huge difference she has made on the claim. I could not have asked for any better outcome and I do not know of another case manager that could have done what she got done on this claim." JS - CCMSI