Telephonic Medical Case Management
ADM’s Telephonic Case Managers (TCMs) have the ability to quickly and effectively interact with employees, providers and employers. These timely interactions lead to the services needed to return employees to work in a safe, cost-effective and timely manner. We understand that the ability to quickly provide information regarding convenient, appropriate access to medical care can have a positive impact on case outcomes. Our TCMs have expertise in the following areas:
• Medical Triage
• Clinical Assessment
• Interviewing Skills
• Medical Terminology
• Medical Planning and Goal-Setting
• Musculoskeletal Injuries
• Physician and Ancillary Provider Communications
• Return-to-Work Coordination
• Therapy and Work Hardening Coordination
TCM Referral Criteria
The following are some of ADM’s standard criteria for referral to a TCM:
• Lost time greater than 5 days
• Modified duty expected to last more than 10 days
• At-risk diagnosis
• Cumulative trauma (back and joints)
• Joint injuries
• Fractures
• Injury of multiple body parts
• Re-injury of same body part
• Underlying medical condition
• Treatment plan that includes more than 2 follow-up appointments
• Physical therapy more than 10 visits
• Treating with specialist, including chiropractor
• Injury occurs within first 90 days of employment
• History of previous work-related injury or injuries
• Attorney involvement
ADM’s standard of practice requires the TCM to initiate the four-point contact within 24 hours of receiving the referral. This four-point contact includes the employee, employer, medical care provider, and adjustor.