ABOUT
FARA's Medical Case Management is comprised of Triage Nurse Case Management, Telephonic and Field Case Management and Medication Case Management. We employ the most experienced Nurse Case Managers, in fact our nurses on average, have over 20 years of clinical nursing experience.
I wanted to take this opportunity to praise the work of your Nurse Case Manager program as it relates specifically to our account. When I started with my company over 14 years ago, I saw a need to consolidate our case management program to be more efficient in assisting our injured employees in getting the treatment that they needed and to facilitate communication between the inured employee, his physician and, of course, the employer. In those 14 years I have been fortunate enough to have the benefit of experienced case managers who have come to know our company as an employer and have taken the time and effort to learn what programs are in place for our injured employees to get them back to work as early as possible, or, in cases where additional treatment is necessary, to be familiar with the local community to facilitate the treatment that they need to be in a position to return to work. I feel that this has been very beneficial to us and, most importantly, to our workers who need assistance and guidance when dealing with a work related injury.
- Jeffrey C., Claims Manager
Our triage nurse case managers offer early intervention into the claims process. Studies have confirmed that early intervention has a positive impact on the injured employee's experience, the appropriateness of the medical plan of care, more timely return to work and decreased overall claim payment exposure. We practice a holistic approach and offer case management services at the inception of the injury with identification of those claimants that have greater exposure potential and, in conjunction with other team members, develop a plan of action.
If the case is a candidate for telephonic case management, the nurses will first choose to contact the injured party and the employer to conduct interventions to produce a cost-effective and safe outcome. The nurse case manager team is committed to being good stewards of our client's financial interests. We are focused on decreasing the medical management cost to our clients while achieving improved outcomes for the injured party.
A referral is made to a field case manager when it is determined that more direct contact with either the injured worker or the provider is necessary to return the injured party to a pre-injury physical status. To meet the objective and goals in the case, the field nurse case manager will complete the necessary coordination of care that may include several services within FARA's Healthcare Management.
Our field case management program is designed to obtain results with the least financial impact to the client. To assure that costs are kept at a minimum, our services are offered on a task assignment basis or services are engaged if the case requires more in-depth service such as catastrophic or high-acuity cases.
In our industry, prescription medications are a significant portion of the claim cost. Industry studies are indicating the prescription share of the medical cost is 18 percent of the total spend. FARA case managers joined with our pharmacy benefit management partner to address this exposure and develop ways to reduce the staggering costs. The program's objective is to ensure the safety of prescribing patterns and to identify opportunities to decrease medication expenditures.
