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Nurse Claims Management

Nurse Case Management
 

NURSE CASE MANAGEMENT:
Claims Management Services

IPMG Claims Management Services offers an internal medical case management program that offers several services that are customizable to meet the specific needs of the client with the focus on the Right Result. IPMG Case Management Program incorporates industry standards and utilizes evidenced-based medicine guidelines in their daily practice of case management to improve the quality of care while saving medical and disability costs.

The services provided include:

Triage

IPMG Case Management offers an integrated service that evaluates the severity of the injury, disability and impact of co-morbidities to determine the necessity of appropriate case management services.

Case Management

IPMG offers a telephonic case management program that may be utilized early in the case and at any time throughout the claim duration. The cost savings is facilitated through early return to work, network steerage, medical necessity reviews, coordination of services, evaluation of cost effective treatment options, discharge planning, and negotiations.

Behavioral Health Case Management

IPMG Case management offers specialized expertise in the areas of behavioral health.

Medical and Disability File Reviews

IPMG Case Management utilizes evidenced based medicine criteria to address the medical necessity of services that are outside of the utilization review process. Case Managers complete causal relatedness and disability reviews.

Independent Medical Evaluation Scheduling and Coordination

IPMG Case Managers assists with the scheduling and coordination of Independent Medical Evaluations.

Employee Health Management

IPMG Case Management is a key team member of the Health Management Resources Team that is a multidisciplinary team approach to promote employee good health with cost reduction realized in medical and disability dollars through identification of “at-risk” employees. Case management works with patients with chronic conditions to reduce the risk of further complications and impacts on workers’ compensations claims.

Utilization Review

IPMG CMS partners with select vendors to provide utilization review services specific to the regulatory and clients’ requirements. IPMG offers partners that are URAC compliant Utilization Management programs that are designed to positively impact claims costs and provide savings to the claim.

Specialty Drug Program Review

IPMG Case Management offers specialty drug review that facilitates early identification of cost savings opportunities with early triggers to case management review.

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