Managed Care

How case management for workers’ compensation benefits employers & employees

Melissa Mills
How Case Management for Workers' Compensation Benefits Employers & Employees
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Published on May 4
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Having an employee injured at work is a stressful and busy time for you as the employer. When you have a MCO like Sheakley UniComp, your case managers will support you and your injured employee through the workers’ compensation system with the common goal of returning your employee to work in a safe and timely manner. Review our list of key benefits of case management for both employees and employers.

Key Benefits of Case Management for the Employer and the Injured Employee

Employee

  • Promote Wellness, Not Illness – We live in a caregiver society, many times taking care of others before ourselves. The Case Manager will work with your injured employee to set “self-care” goals and assist them to meet those goals and return to work. Research shows that a speedy return to work helps the employee feel more useful.
  • Reinforcement of the “Going to Work” Habit – Aristotle once said, “We are what we repeatedly do”. So, the best way to get the injured employee to return to work is to talk about it and set goals with specific end dates that leads them on the road back to the work place.
  • Effective Early Treatment – Not only will the Case Manager ensure that your employee gets the proper treatment, but they also ensure it is the right treatment at the right time delivered by the right provider. The BWC provides a “presumptive” period of 60 days from the date of injury. During this time, most diagnostic testing and treatments are approved without the MCO making a treatment decision. This period of time facilitates early treatment, which has been shown to facilitate optimal outcomes for the injured worker. Your Case Manager takes advantage of this period of time to ensure that all needed testing and treatment is completed early. This ensures that the correct diagnoses are added to the claim and treated appropriately from the onset of treatment.

Employer

  • Communication – Worker’s Compensation Case Management has been said to have the highest number of stakeholders of all case management types. This requires that every Case Manager be highly skilled in communication and collaboration. Your Case Manager will have information for you from the employee, their attorney and all providers involved in the care of your employee. This will provide you with a whole picture of the claim to make the best decisions for your company.
  • Decrease Cost of the Claim – Our Case Managers work closely with the Utilization Review team to ensure that medical costs are contained. While we want to provide the right treatment for the employee, we also want the treatment to have end with the common goal of return to work with the lowest cost.
  • Active Participation with the Employee – By speaking early and often with your Case Manager, you have a direct line of communication with the employee. The Case Manager can assist with facilitating communication between you and the employee to ensure a safe and timely return to work. This facilitation helps the employee to feel connected to their workplace and provides you wilt the information you need to maintain production.

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