Medical Case Management
The purpose of the Medical Case Management Program, or Case Management, is to help coordinate the medical treatment services provided to injured employees for their work-related injuries. This is done through a Case Manager that assists in obtaining medical treatment and is used to promote the most cost-effective treatment without compromising the patient's quality of care.
Is Case Management Required?
No. Employers or insurance adjusters may, at their own expense, utilize case management but it is not required. If utilized, injured workers must cooperate with the case manager.
Case Management services shall include, but not be limited to:
- Developing a treatment plan to provide appropriate medical services;
- Monitoring the treatment and medical progress;
- Assessing whether medical services are appropriate and delivered in a cost-effective manner, based on acceptable medical standards;
- Ensuring that the injured employee is following the treatment plan
- Formulating a plan for return to work, with due regard for the employee's recovery, restrictions, and limitations, if any.
Register as a Case Manager
Nurse Case managers are employed by the insurance carrier as they coordinate the medical diagnostic and treatment services provided by the authorized treating physician to the injured employee.
Case Managers must register with the Bureau prior to providing services involving Tennessee Claims. Registration may be faxed, (615) 253-5265, or mailed to:
Attention: Medical Case Management Coordinator
Bureau of Workers' Compensation
220 French Landing Drive, Suite 1B
Nashville, TN 37243