MEDICAL CASE MANAGEMENT SERVICES

The Star Group, Inc. is a private company, with expertise in providing medical case management services. We can work in concert with insurance carriers, attorneys, government departments, as well as other organizations and agencies. We have experience in providing medical case management services in Workers’ Compensation, No-Fault Auto Insurance, Liability Claims, Welfare Cases, Disability Claims, etc.

We have the expertise and capability to tailor programs and services to meet your needs with our "Solutions That Achieve Results".

Our Medical Case Management Services include:

• Medical Case Management Assessments
• In person meeting with the claimant
• Indentifies current status and sequela.
• Gathers previous medical histories.
• Assesses for objective versus subjective findings.
• Assess familial, environmental and motivational issues.
• Addresses specific issues and areas of concern.
• Assesses appropriateness and cost of care.
• Formulates rehabilitation plan.
• Creates benevolent relationship.
• Medical Case Management
• Ensures progressive and appropriate care.
• Promotes recovery and a return-to-work focus.
• Ensures compliancy.
• Educates the Client
• Ensures cost-effectiveness.
• Fosters benevolent relationships and communication between parties.
• Acts as a direct liaison with care providers.
• Expedites the rehabilitation process.
• Medical Management for a Return-to-Work
• Educates treating physicians on Client’s job options.
• Advocates for light duty, early, and safe return-to-work options with treating providers.
• Ensures communication between Client and employer.
• Negotiates for job modification and accommodations.
• Identification so as to overcome unrelated job barriers.
• Advocates for Clients reemployment opportunities.
• Physician/Treatment Provider Meetings and Appointments
• Attends Client’s appointments with physicians and treatment providers.
• Ensures communication between treatment providers, physicians, and Client
• Educations physician on Client’s job duties.
• Opportunity to initiate and discuss proactive treatment plans.
• Identifies and negotiates safe return-to-work releases and timeframes.
• Advocates for Client as indicated.
• Can address issues of causality and relatedness.
• Can establish timeframes and plans for continued care.
• Addresses restorative versus palliative care.
• Assesses for overtreatment and ensures care is goal-oriented.
• Records Review/Compilation
• Reviews for pre-existing conditions and treatment.
• Assesses for issues of causality.
• Reviews for compliancy issues.
• Identify complicating or hindering factors.
• Review for ETOH, drug involvement.
• Identifies missing records or lapses in treatment.
• Organizes medical files in chronological order.
• Prepares files of IMEs, Peer Reviews, FCEs, or Radiological Reviews.
• Address issues of negligence or liability.
• Hospital Discharges
• Assesses for appropriateness of discharge.
• Ensures cost-containment.
• Coordinate post-discharge needs.
• Evaluations and Testing (see Evaluation and Services Section for more information)
• Independent Medical Evaluations.
• Psychological Evaluations, Assessments, and Review.
• Functional Capacity Examinations.
• Peer Reviews.
• Independent Radiological Reviews.

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The Star Group, Inc. 2010