Medical Case Management

Cost Savings Begin at the Beginning of the Claim

The simplest way to contain the costs of medical care for injured and ailing workers is to control spending from the outset of the claim.  AMC Medical Case Management stresses early intervention to assure an optimal treatment plan that maximizes cost containment.

AMC Medical Case Management is designed to integrate and support your management’s goals and objectives for cost containment.  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
• Life Care Planning for catastrophic conditions
• Ergonomic Evaluations
• Specialty Peer Review

We use only those services you need, and only those that will facilitate rapid achievement of medical stability at the lowest 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

1. Measurable objectives
2. Realistic timeframes
3. Reasonable costs of care

• Actively manage the case so that medical providers and patients are held accountable for progress; encouraging quicker 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.