Case Management

ExamWorks Clinical Solutions is accredited for Case Management by URAC.

ExamWorks Clinical Solutions' (ECS) Case Managers work closely with the injured worker, physicians, medical teams and the claims professional to provide direct medical intervention and facilitate the delivery of a quality and cost-effective case management solution.

Our Case Managers have years of relevant industry experience, exceptional levels of professionalism and outstanding communication skills. They collaborate with quality assurance and other professionals to devise solutions that deliver the best outcome. Our bilingual Case Managers assist injured workers, their families and the health care team to improve outcomes through claimant education and communication.

Field Case Management

Our Field Case Managers develop medically necessary and appropriate treatment plans in conjunction with the treating provider.  They expedite care and coordinate return to work for the injured worker by evaluating work history, educating the injured worker and maintaining communication among all parties. ECS Case Managers establish an aggressive action plan for the injured worker to achieve an optimal level of functionality and a timely return to work.

Catastrophic (CAT)
Case Management

The ExamWorks Clinical Solutions' CAT team provides an informed and quick response to injured workers who experience a tragic event with a sudden long-term, life-altering result. Our CAT team is available 24 hours a day, 7 days a week, 365 days a year. Round the clock availability ensures an expedited response, provides immediate triage, collects required information quickly and accurately and offers support to the injured worker and their family.

CAT Case Managers initiate recovery solutions by coordinating services and using a multi-disciplinary approach to work with the treatment team of physicians, therapists, insurance carriers/TPAs and community resources. Our team of experienced Case Managers navigates the medical maze of these more difficult and extended cases to achieve the best outcomes and functionality.

Telephonic
Case Management

Our Telephonic Case Management service is an early intervention platform for customers to expedite an injured worker's recovery. From the onset of the injury, our Case Managers expedite appropriate medical intervention and manage cost-effective treatment protocols, promoting a safe, early return to work with immediate medical cost savings.

Vocational
Case Management

Our Vocational Case Management service conducts labor market surveys, facilitates job searches and provides physical capabilities and transferable skills analysis. Through state-of-the-art vocational tools, our Vocational Case Management experts develop action plans to expedite the injured worker’s return to gainful employment. A safe and expeditious return to work is the Case Manager’s priority.

Complex Cases

Our Solutions Center provides Medicare Set-Aside (MSA) resolution services, complex claim management recommendations, clinical negotiation services and resource coordination. Solutions Center nurses have Life Care Planning credentials and MSCC certification and work in conjunction with our case management and Medicare compliance experts, offering an integrated complex claim and pharmaceutical solution. Contact us to learn more about the commitment, investment and applications available to clients through the ECS Solutions Center.