What is Medical Case Management?
The Medical Case Manager coordinates medical care and provides ongoing communication between the injured worker, employer, medical provider, and insurance carrier. A Medical Case Manager is assigned to manage the care of an individual to promote a safe and timely return to work. This may include the identification of a temporary light duty position or the development of a permanent modified duty position when medically appropriate. This coordinated effort helps control costs and provides effective medical care.
How Can Medical Case Management Help Me?
Medical Case Management has various benefits for individuals who would like to avoid the complications of navigating their medical case.
At Stubbe Case Management, our staff can:
- Assess current medical treatment
- Coordinate medical care
- Evaluate medical recommendations
- Streamline care to facilitate recovery
- Provide ongoing contact with all involved health care providers
- Teach and encourage clients to comply with recommended treatment modalities
- Negotiate costs for medical treatment, medications, and durable medical supplies
- Bring a client to maximum medical improvement
What Do We Cover Under Medical Case Management?
24/7 Nurse Triage
What is 24/7 Triage?
24/7 Nurse Triage is designed to provide the appropriate level of evaluation and treatment at injury onset. Treatment in emergency rooms can result in high costs, increased indemnity, and cumbersome care. However, there are ways to avoid these complications while an injured or ill worker heals.
Nurse Triage is a Workers’ Compensation program formulated for individual employers to reduce costs and improve the recovery time of workplace injuries. Our Registered Nurses are on call seven days a week, twenty-four hours a day. As soon as an injury is reported—even if the individual is still on the worksite—the employee is directed to immediately call the triage service.
Oftentimes, an initial injury requires nothing more than rest and self-care. If the injury requires medical treatment beyond first aid, the employee is directed to the employer’s occupational health clinic.
Triage Nurses record, refer, schedule, track, and follow up on all injuries.
Life Care Planning
What is Life Care Planning?
Life Care Planning and Medical Cost Projections Life Care Planning is a method that analyzes and estimates medical damages resulting from an injury or illness.
Through this plan, a case manager will provide a detailed, comprehensive outline of the current and future medical, vocational, educational, and psycho-social needs of a catastrophically ill or injured individual. The plan identifies what care is needed while a case manager projects the individual’s related costs—whether annually or over an individual’s life expectancy.
Some of the catastrophic illnesses that commonly occur for individuals seeking this service include
- Spinal cord injury
- Traumatic brain injury
Catastrophic Case Management
What is Catastrophic Case Management?
Catastrophic Case Management is for some of the most severe injuries. Stubbe Case Management offers RN nurses who specialize in the severest of cases and have several years of experience in providing catastrophic assessments.
Injuries considered catastrophic may include:
- Major amputations
- Severe burns
- Severe brain injuries
- Spinal cord injuries
- Multiple trauma
- Severe toxic chemical exposures.
They also follow up for Medical Case Management services. Stubbe’s Case Management nurses are knowledgeable about various Centers of Excellence for specific injuries throughout the country.
Telephonic Case Management
What is Telephonic Case Management?
Telephonic Case Management is an early intervention cost containment service for workers’ compensation happening within a short time frame—usually 30-90 days.
When a file is assigned to a telephonic case manager, the nurse contacts the claimant, employer, and physician to obtain the specifics of the treatment plan. Some injuries covered in telephonic case management include
- Cardiac conditions
- Chemical exposures/inhalation exposures
- Crushing injuries
- Electric shock
- And many others.
Minnesota Statutory Case Management
What is Minnesota Statutory Case Management
According to Minnesota Statutes, “Rehabilitation is intended to restore the injured employee so the employee may return to a job related to the employee’s former employment or to a job in another work area which produces an economic status as close as possible to that the employee would have enjoyed without disability. Rehabilitation to a job with a higher economic status than would have occurred without disability is permitted if it can be demonstrated that this rehabilitation is necessary to increase the likelihood of re-employment. Economic status is to be measured not only by opportunity for immediate income but also by opportunity for future income.” – 176.102 REHABILITATION
What is South Dakota Certified Managed Care?
The South Dakota Workers Compensation system strives to ensure that workers are able to obtain prompt medical care to return to work as quickly as possible. Stubbe Case Management is a Certified Case Management Organization in South Dakota. Our case managers facilitate communication between all stakeholders.
14525 Highway 7, #365
Minnetonka, MN 55345
Toll Free: 1-800-478-8223
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