Field Medical Case management: An innovative approach geared to assist all parties involved with the claim.

Due to the critical and challenging changes within the Workers’ Compensation system in 2003, 2004 and beyond, there are many advantages for the Applicant Attorneys’ to utilize Medical Case Managers.

Our Medical Case Managers coordinate and assist the Injured Worker in scheduling appointments, facilitating authorizations for diagnostic testing, durable medical equipment and medications. Often, there are vast differences in philosophy among Insurance Carriers, Third Party Administrators and Self Insured/Self Administrators regarding the implementation and interpretation of the Utilization Review process.

Our Medical Case Managers have experience working with these various entities and with many of their Claims Examiners. Depending on the philosophy of the Insurer, there are frequently occasions when the Medical Case Manager is able to provide the Claims Examiner with a specific rationale that can facilitate the treatment plan or procedure that may otherwise be delayed or denied.

Additionally, Applicant Attorney overhead is drastically reduced with the use of Medical Case Managers who intercept frequent telephone calls, answer questions and address the concerns of the Injured Worker, otherwise directed to the Legal Assistants or Clerical Staff in the Attorney’s absence. PrimeCare Managed Care, Inc., is an Independent Medical Case Management Company that can be effectively utilized as an Agreed Case Management Evaluator on active, serious or catastrophic claims requiring inordinate time and attention from the Attorney Representative.

Our goals and objectives are to provide a superior service to all the parties involved with the claim. Particularly, the Injured Worker, by providing support and facilitating the medical treatment plan as recommended by the Treating Physician or Physicians responsible for the patient’s care. Many Applicant Attorney firms in the Southern California area are familiar with our Company, welcome our assistance and authorize our intervention. Those references will be furnished upon request.