Medical Case Management

Onsite Case Management

Medical case management at MEDComp South, Inc. starts with our nurse case managers, highly skilled registered nurses who are experienced in dealing with the complexities and nuances of Workers' Compensation cases. Our case management service focuses on assessing and coordinating medical treatment and helping injured workers heal and return to the workplace as soon and as safely as possible. Drawing on our extensive experience, we have designed a system that enables us to deliver prompt and successful resolutions to claims.

Upon receipt of your referral, MEDComp South, Inc. will contact the injured employee, the insured, healthcare provider, and insurer to begin the evaluation process. The extent of injury and the concerns of the injured worker, insured, and healthcare provider are documented. We then move to establish case resolution objectives, provide an action plan, and begin coordinating care for the injured worker to successfully and promptly resolve these issues. We also look below the surface for underlying issues such as language, cultural misunderstanding, pre-existing medical conditions, and psychological and emotional factors that can influence the case.

Telephonic Case Management

When case management assignments don't need an on-site nurse, a MEDComp South, Inc. case manager can provide telephonic support. Interacting with the injured worker, insured, healthcare provider, and insurer, we guide the case to prompt and effective resolution.

Catastrophic Case Management

When life-threatening injuries occur, you can call on one of MEDComp South, Inc.’s experienced case managers to be on the spot to manage the case from the date of injury, ensuring appropriate care, attention to details, and support for the injured worker and his/her family. The nurse will follow the case from initial emergency care through treatment, rehabilitation, and home modification, concluding with the individual's return to work or end of healing.

Medical Only Case Management

Medical Only Case Management offers an objective assessment for medical direction.

MEDComp South, Inc.’s specialized case managers review medical files and reports and provide you with a specific evaluation of the injured employee's medical status, healthcare and prognosis. Medical Only Case Management can help you determine when it is appropriate to close a case, and keeps insureds "in the know" and involved in managing their healthcare costs.

Referrals for this program should be made if:

• litigation is imminent and there is no contact with the injured worker;
• the injured worker has been terminated;
• the insured needs a second opinion, medical records or an assessment of maximum medical improvement status;
• medical treatment has not been rendered; or
• medical treatment is questioned.

Specialty Intervention Management

This unique program offers you a 30-day solution that integrates resources and action plans either as a specific or limited assignment.

MEDComp South, Inc. case managers review medical records then communicate with the insured, the injured employee and the medical providers to accurately evaluate the association between the employee's health, the medical treatment and the return-to-work plan. One visit is made with the physician, client or injured employee, allowing the case manager to be consultative and impact the case in the most timely manner. The insured is provided with a medical and occupational overview, documenting case status and prognosis of the employee's return-to-work expectations.

Referrals should be made to the MCS Specialty Intervention Program when:

• there is uncertain medical status
• Second opinions are needed
• Early intervention is key to facilitating timely case closures

Implementing the MEDComp South, Inc. Specialty Intervention Management Program helps prevent a case from escalating, thereby reducing medical expenditures, and returning injured employees back to work sooner.