Problem
An employee at a senior living facility fell over three feet into a concrete pit while examining a generator at work. The fall resulted in a fractured shoulder, eight fractured ribs and a punctured lung.
Solution
Two days post injury, a telephonic case manager (TCM) was assigned to the case. The TCM worked closely with the injured employee throughout her hospitalization, short-term acute rehabilitation, return home and outpatient therapy. Communicating closely with the injured employee, medical providers, the employer, and claims professional, the TCM removed obstacles related to obtaining doctor’s orders and reports, kept track of approved treatment, ordered equipment and provided education to the injured employee. The TCM worked to establish trust with the employee ensuring she was engaged in her recovery and motivated to return to work.
Outcome
The use of early intervention jump-started the injured employee’s recovery, ensuring she had the right care at the right time. This strategy allowed her to return to work 24 weeks sooner than ODG benchmarks. The care and compassion for the injured employee delivered a favorable outcome for the insured and the customer.
Injured employee returned to work 24 weeks sooner than ODG benchmarks
$36,569 in medical savings
My TCM guided me through the many, many questions and challenges I encountered. She was always willing and able to provide education and assistance on a timely basis and could be relied upon to follow through and follow up. Her attentiveness to my care needs made it virtually unnecessary for me to call her or my employer to obtain the information I needed. Every aspect of the Care Management I received was excellent.
Injured Employee