Story From the Case Management Trenches

Ms. Brown was in a skilled nursing facility for rehabilitation of a work-related injury.  She was receiving physical therapy at the facility, but needed transportation to and from her MD appointments.  The account was advised of the client’s needs and provided the case manager with the name and number of their preferred transportation vendor.  A precursory search for transportation was made by the case manager prior to being advised to use the carrier's preferred vender.  When the pricing was obtained from the preferred vendor it was questioned by the nurse case manager--it was significantly higher than the transportation company utilized by the nursing facility.  Not all venders improve the bottom-line cost of the claim! 

Story From the Case Management Trenches

As workers compensation field case managers we must work within the guidelines of our accounts while looking out for the safety and health of our injured worker. These two goals do not always mesh.

A call was received from the extended care facility that Ms. Brown was ready for discharge in two days—a Thursday.  The consultant asked if she would be able to take the walker she was using in the facility home with her.  The facility said no and this consultant then advised the account that the client would need to have a walker delivered to the extended care facility so that it could be modified to fit the patient prior to her discharge.  Unfortunately the MD was in surgery on this day and could not provide the script for the walker until Wednesday, the day prior to discharge.  The account kindly advised that they would contact their preferred provider to supply the client with the walker.

 

Thursday morning arrives and the injured worker is contacted and states that she has not received her walker, but did receive a call from the vendor asking if they could deliver her walker at home rather than at the nursing facility as “it was more convenient for them”.  Luckily, this injured worker knew the importance of obtaining a walker for safe mobility from the nursing facility to her home.  She told the vendor that she needed the walker to be fitted before she went home.  She contacted her nurse case manager and told her what transpired this afternoon and was assured that she did the right thing to ensure her safety.  This is just one example of preferred vendors not realizing that the safety of the injured worker takes precedence over the convenience of the vendor. 

Wishing all of you a very happy Mother's day!