Medical Case Management

Lowering Costs Across the Life of a Claim

The simplest way to contain medical care costs for injured and ailing workers is to control spending from the outset of the claim. At AMC, we stress early intervention to assure an optimal treatment plan that maximizes outcomes.

Our medical case management integrates with and supports your cost containment goals and objectives. This customized approach establishes referral criteria and incorporates a combination of case management skill sets unique to your organization, which may include:

  • Field or telephonic nurse case management
  • Utilization management
  • Hospital bill audits
  • Specialty peer review

We use only those services you need, and only those that will facilitate achieving medical stability at the best possible cost.

Nurse Case Management

The foundation of our approach is telephonic and field nurse case management protocols designed to:

  • Identify any barriers to recovery and return to work
  • Clarify medical diagnoses and identify pre-existing or non-related conditions
  • Design and execute treatment and return to work plans in conjunction with the injured worker and the medical provider that incorporate
    • Measurable Objectives
    • Realistic Timeframes
    • Reasonable Costs of Care
Actively manage the case by holding medical providers and patients accountable for progress; encouraging timely recoveries and earlier case resolution
  • Direct care to medical provider networks or preferred provider networks to earn additional savings beyond state fee scheduled allowances
  • Negotiate prices for treatment, equipment and supplies to control costs
  • Propose cost-saving alternatives to recommended treatment that do not compromise the quality of care

To learn more about medical care cost savings, call (800) 431-6336.