Systemedic customizes our medical case management services to meet the individual
needs of our customers. The process is seamless from referral to case closure and can
be initiated at any time.
Systemedic case managers are registered nurses with strong clinical backgrounds. Our case managers are expected to become certified case managers (CCM) within twelve to eighteen months of hire. Our case managers cover Arkansas and the surrounding areas. Because of our experience in Arkansas claims, our relationships with Arkansas providers allow for quick access to physicians and services.
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Indicators for referral
Onsite Case Management
This service is appropriate for claims that involve serious, complex, or catastrophic injuries or chronic pain. These types of claims require more intensive intervention and monitoring to direct the claim toward the achievement of maximum medical improvement.
Onsite case management is also recommended for claims with issues that negatively impact progression to recovery. Onsite case managers provide in-person contact with the treating physicians and injured workers to discuss the medical assessment, treatment plan, and progress toward achievement of maximum medical improvement.
At times, one-time onsite case management services may be needed to attend a physician appointment with the injured worker to obtain specific information, or just to meet with an injured worker to review the injury, treatment, progress in recovery, and use of equipment of supplies as directed by our customers.
Detailed updates are sent immediately following all encounters with the injured worker or treatment providers. A comprehensive formal report is provided as well.
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Focused Service Task
At times, full case management services may not be required, and a focused service task is more appropriate to meet our customer needs. This service is available, as requested, for claims requiring assistance in obtaining clarification or documentation of maximum medical improvement, impairment rating or work status, coordination of appointments, treatment and/or care, or scheduling of testing such as Functional Capacity Evaluations without the need for formal case management. It may also include assistance in identifying medical specialists and other providers, completing post-hospital discharge tasks including home care, wound care, and durable medical equipment needs, arranging specialized injured worker follow up or other tasks as needed to address issues specific to the injured worker. All focused tasks are completed by our RN case managers with timely updates and detailed communication.
Telephonic Case Management
This service is provided as requested to obtain timely medical updates from injured workers and medical providers. All nurse case managers are registered nurses with the same requirement for certification in case management.
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If during telephonic case management, our customer requests transferring the claim to onsite case management for any reason or requests a one-time onsite meeting with providers or injured workers, the nurse case manager will perform these duties to maintain continuity in the claim, unless otherwise directed.
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Detailed updates are sent immediately following all encounters with the injured worker or treatment providers. A comprehensive formal report is provided as well.
