Case Management


WORKERS’ COMPENSATION

Effective case management can lower the total cost of claims, limit indemnity exposure, trim legal expenditures and control medical costs. At GMSI, our on site case management and vocational rehabilitation programs help the injured worker achieve maximum medical improvement and swift return-to-work while ensuring that only appropriate, cost effective care is utilized. Our highly trained RNs and vocational case managers are accustomed to handling the most difficult cases. Their experience coupled with their knowledge of local medical providers, suppliers, facilities, employers and community resources-enables them to control costs and quickly move cases towards successful resolution.

 

     Medical Case Management

  • Telephonic and Field Case Management
  • Early Intervention
  • Medical Records Review
  • On-site Occupational Nurses
  • Legal Nurse Consulting
  • Specialized Resources Identification

Vocational Case Management

  • Vocational Testing
  • Transferable Skills Analysis
  • Job Seeking Skills Training
  • Job Placement
  • Job Task Analysis
  • Modified Duty Programs

 

 

 


 

GROUP HEALTH SERVICES

Employers face increasing health care costs and employee expectations relative to care and support. Employee health benefit programs require comprehensive, flexible provider options with assisted access to the healthcare system. GMSI’s healthcare management programs offer choice, access and results for your employees while controlling and managing costs. GMSI’s Group Health menu includes a continuum of services designed to advocate and deliver quality care, attention, and support for employees while looking out for your best interest relative to healthcare expenditures. Our services are designed for access and entry at any point in the healthcare continuum.We ensure that the employee receives appropriate treatment in the most conducive setting to drive optimum outcomes.


 

TELEPHONIC CASE MANAGEMENT

Telephonic case management (TCM) has proven to be one of the most effective strategies for early intervention. This powerful cost containment tool combines our expertise in case management, utilization review, medical criteria, physician advisors, and cost-effective telephone contact.

TCM allows everyone involved to work as a team – claims handler, employer, providers, and case manager. This team approach ensures that recovery goals and return-to-work plans are quickly established and monitored. In addition, TCM can include the timely involvement of panel physicians or a PPO.


 

SHORT TERM AND LONG TERM DISABILITY

GMSI case management services provide a means to determine if continued payment of benefits is warranted in short-and long-term disability cases. Realistic medical and vocational assessments are designed to define a claimant’s ability to work, and expedite recovery and return-to-work. GMSI case managers have the knowledge and skills to accurately identify and resolve “own occ” and “any occ” cases. GMSI also facilitates workers’ compensation, social security, or other offsets. And our case managers serve as “goodwill ambassadors” for the client on behalf of the insurer.


 

AUTO AND GENERAL LIABILITY

Lowering costs in liability claims – both medical and legal – is a proven result of the use of case management. The individualized attention that claimants receive from GMSI promotes a positive environment and open communication. And we provide claims adjusters with valuable information and recommendations to control medical costs. Services are provided by Registered Nurses and Vocational Case Managers specially trained in handling liability cases.