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06-10-1996 Council Agenda
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06-10-1996 Council Agenda
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LEAGUE MN CITIES TEL :612- 281 -1298 May 31 96 8 :34 No.005 P.03 <br />* To evaluate each episode of medical care and address the procedural <br />necessity and eliminate settings that seem questionable <br />* Manage standard of care and present the most efficient and effective plan <br />of treatment <br />* Channel injured employees into the most appropriate network <br />Active Can Management <br />Certainly from both the employer's and employee's perspective, the ultimate goal of treating any <br />workers compensation injury Is to bring the injured worker back into the work force if at all <br />possible. To that end, care managers work with the injured worker, their family, and their <br />treatment provider to: <br />* Arrange for alternative treatment when necessary <br />Support and encourage return to work efforts with the employee and <br />employer <br />* Arrange for physical rehabilitation services <br />* Arrange for needed supplies or equipment <br />* Educate injured workers and their tbmiiies <br />* Facilitate employee's return to work. Monitor primary duties and consult <br />with employer about increased workload and/or the liifting of weight <br />restrictions <br />* Coordinate vocational counseling <br />Case managers also serve as advocates for the injured worker by acting as a liaison between 1) the <br />employer and the employee, 2) the employee and his/her medical provider, 3) the employee and <br />the LMCIT claims staff, and 4) the medical providers and the claims staff, <br />Review of Medical Bills <br />A final cost savings factor associated with managed care involves ongoing review of medical bills <br />submitted by medical providers. This ongoing review assures that only those tests and treatments <br />which are pre - authorized and/or medically necessary will be recommended for payment. <br />2 <br />Page 42 <br />
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