Customized case management provided by experienced, professional Registered Nurse:

• Comprehensive, independent assessments of injured worker medical status through entire claim episode
• Evaluates need for on-site case management services
• Review medical records for appropriateness of care and progress
• Flexible services according to employer and/or adjuster requests

Teamwork is key to successful case management

• Timely 3-point contact
• Ongoing communication with all parties, including the injured worker; medical providers; employer; and insurance adjuster/carrier
• Application of medical disability guidelines
• Facilitate well designed medical plan
• Monitors medical status
• Coordinating immediate referral for field case management in catastrophic or medically complex cases
• Provide education to injured workers and adjusters regarding medical management
• Facilitates (correct communication of) pre-authorization needs
• Coordinates referral for long term or life care planning

• Assessment includes recommendations for reaching MMI/MRC
• Coordinates IME/RME/Peer Review Services
• Advocates and facilitates appropriate and timely return to work

Case Evaluation - CIA will review the claim and provide it's partner with a comprehensive analysis of the treatment plan with the current medical provider

• Review claim file, medical reports and information
• Compare current treatment to medical and occupation disability guidelines
• Identify impact of pre-existing medical conditions
• Provide assessment/evaluation of current medical treatment plan

Implementation of Analysis Evaluation - sometimes our partners want more than just an "Evaluation" or "second look" by CIA.  We created this level of service with assisting in the management of the claims by the implementation of CIA recommendations.

• Communicate directly with adjusters/providers regarding injury related treatment
• Provide guidance for monitoring the medical and return to work plan
• Provide recommendation regarding treatment authorizations and general plan of care for reserving purposes

Active Telephonic Case Management - This level of service is for those partners that want CIA directly involved in the administration of the claim.  Beyond just reviewing and making recommendations, in this capacity CIA is involved with assisting the partner in the decision making process.

• Assess need for/facilitate on-site field case nurse
• Provides medical case management to achieve goals of med plan and best possible outcome
• Monitors / oversees field case nurse manager to achieve goals
• Recommends alternate options for medical care including outside  medical review/expert opinion to facilitate claim resolution