ACCURATE’s telephonic case management (TCM) program focuses on a proactive review and evaluation of treatment options, a strategy that stresses early intervention to successfully manage medical issues and contain costs, and may be utilized when appropriate to facilitate file movement.
Telephonic Case Management Referral Criteria:
- Inpatient hospitalizations
- Cumulative trauma with anticipated loss time
- All cases with over 14 days anticipated TTD
- Inconsistent medical findings, including subjective complaints that cannot be supported by objective findings
- Multiple treating physicians
- Frequent change of primary treating physician
- Pre-existing conditions that may prolong treatment (i.e., diabetes, hypertension, heart problems)
- Non-compliant treating physicians
- Continued treatment with no MMI in sight
- Roving diagnosis-continually changing diagnosis
