Managed Care Case Management - Workers' Compensation TPA Services
General Liability Claims Service, Commercial Property Claims Service
Adjusters screen all first reports of injury. Only those meeting
select criteria established by you are referred to
medical management professionals. The case manager initiates
the case management process by contacting the treating physician
to:
General Liability Claims Service, Commercial Property Claims Service, TPA
- Establish a treatment plan and discuss appropriateness
of care
- Review treatment or recommended tests that require pre-certification
- Schedule follow-up consultation
TPA services, workers compensation TPA
Services requiring pre-certification are
reviewed to confirm:
- Medical necessity and appropriateness
of proposed treatment
- Recording of authorization for future
reimbursement activity
- Scheduling of follow-up consultations
- Transmission of notification to all appropriate
parties
liability claims service
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