MEDICAL
CASE MANAGEMENT (MCM)
OVERVIEW:
Diversified Health Care Management
Consultants, Inc. (DHCMC, Inc.) provides
high quality cost effective case management services by working directly
with injured employees, clients injured in auto accidents, short and
long term disability clients, and the chronically ill. Our case managers
work closely with the client and their health care providers, employer,
insurance company, attorney, and family members to coordinate and
ensure optimal outcomes.
DHCMC, Inc., case mangers
are knowledgeable and creative in exploring the resources available
within the community to assist and meet the needs of our client, the
account, and the employer.
Medical
Case Management: (MCM)
• Worker’s Compensation
• Auto No-Fault
• Catastrophic Injuries
• Coordination of Client Care
• Long and Short Term Disability
• Chronic Illnesses
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DHCMC,
Inc., case managers assist the injured client to obtain appropriate
medical care, reach maximum medical improvement, and return to work
as soon as possible.
• Review all medical records relevant to the case in order to
develop a treatment plan.
• Maintain contact with treating physicians to stay current
on the treatment plan.
• Advise the carrier and employer of all aspects of the case
and status.
• Coordinate care between physicians, rehabilitation specialist,
to ensure continuity of care.
• Coordinate return to work, when appropriate, to full duty
or through a transitional return to work plan.
• Assist with the determination for Vocational Rehabilitation
when appropriate.
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ERGONOMIC
JOB-SITE ANALYSIS (ERGO)
DHCMC, Inc., case managers work with the client,
employer, physicians and occupational therapists, to analyze the physical
demands and the work environment of the job-site. Provide ergonomic,
environmental, and administrative recommendations to modify the job-site
to help the employee return to a safe and workable condition on the
job.
• Assess and determine specific physical requirements of occupation.
• Assess and identify specific requirement of employment setting.
• Work with employers and claimants to modify job-site to accommodate
claimant’s limitations.
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LIFE
CARE PLANNING (LCP)
DHCMC, Inc., Life Care Planners outline the annual
and lifetime costs of care for the life expectancy of the client.
Life Care Planning is a tool used for the purpose of estimating medical
and non-medical needs of the person with a catastrophic injury or
illness. The Life Care Plan addresses and projects the cost and frequency
of needed goods and services over an estimated life span. Life Care
Planning is helpful in adjudication claims, setting reserves and developing
structured settlements essential to catastrophic injuries.
• Presentation of the client's total lifetime needs as the result
of an injury or illness, including projected costs
• Recommendations for current and future needs regarding medical,
psychological, therapeutic, social, equipment, transportation, and
other special needs
• Consultation for review of opposing plans
• Health Care Assessment and needs identification
• Cost Projections
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VOCATIONAL
REHABILITATION (VOC)
DHCMC, Inc., Vocational case managers work with the
injured client to return clients to a medically and vocationally appropriate
position within the work force. Vocational case managers assess the
injured clients functional capabilities, education, and interests
as well as transferable skills to identify appropriate job placement.
Vocational case mangers initiate job development in the client's geographical
area to locate potential positions.
Vocational case managers assist the clients in the following:
• Vocational Assessment and Counseling
• Resume Preparation
• Complete Employment Applications
• Coach Interviewing Techniques
• Vocational Planning
• Labor Market Survey
• Job Development
• Job Search Activities
• Marketing Portfolio
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COST
CONTAINMENT MEASURES
• Employer – Early Return To Work Program
• Early Intervention
• IME (Independent Medical Evaluation)
• Fee Negotiation
• Utilization Management
• Telephonic Case Management
• On-Site Case Management
• Provider Bill Review
• Cost Savings Analysis
