Medical Case Management and Focus CMS

Medical case management is a specialized intervention that is needed when a worker’s compensation claim has become unnecessarily prolonged or when the injury is complex or severe or when the case is medically questionable in some way. In these cases, a nurse or physical therapist medical case manager intervenes by direct, on-site interactions with the injured worker, the doctor, and the other medical providers involved in the treatment plan. The medical case manager has ongoing and consistent contact with the Claims Examiner and the Risk Manager to expedite the appropriate plan of recovery.

At Focus CMS, our clinical benchmarks clearly demonstrate the effectiveness and efficiency of this mode of intervention on “runaway” or “red flag” claims that have already cost significant dollars in the administration of the Worker’s Comp benefit. We welcome the opportunity to prove our expertise to you as self-insured employers, third party administrators, Joint Powers Authorities and Worker's Compensation insurers.

Our clinical staff know what is important to:

• Injured Worker
• Physician
• Employer
• Risk Manager
• Claims Examiner