Our Telephonic Case Management service works to ensure that appropriate treatment and return-to-work plans are established and implemented for all work-related injuries referred to Definiti. Supported by our state-of-the-art software system, our highly qualified and experienced nurse case managers effectively negotiate with injured workers, their provider and employers to achieve timely and cost-effective outcomes. We provide comprehensive outcome reporting to measure and document the quality and effectiveness of the services we provide. Via electronic data interfaces (EDI), we download case process documentation directly into our clients’ claims management systems, facilitating the claims management process.
Telephonic Case Management
Definiti’s nationwide telephonic case management is provided to Self-Insured organizations and Third Party Administrators for workers’ compensation. Our nurses are trained and comply with medical reforms nationwide, such as SB899 in California and Texas House Bill 7.
Our Case Management goals are:
- Develop plans with medical team to return client to optimal level of functioning
- Identify and coordinate healthcare resources
- Develop cost containment strategies through negotiation of services, network usage and utilization review
- Develop long-term plans that will incorporate client’s individual needs
Disability Management
Our Return to Work Management goals are:
- Early intervention focused on the safe and timely return to work
- Explore opportunities for alternative work programs with employers and adjusters
- Work closely with physicians in identifying early return to work opportunities
- Utilization of well recognized disability management criteria to assist employers and physicians in return to work issues.
