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Spooner Managed Care Services (MCS) provide best-in-class medical case management for workers' compensation, and short- and long-term disability claims. Precise triage ensures appropriate assignment of medical treatment and rehabilitation services and determines which type of case management bests suits the needs of the employee. Complex cases are immediately assigned to Nurse Case Managers for early intervention, aggressive case management and healthy return to work.
Field Case Management
Nurse Case Managers personally meet with the injured worker, attend physician appointments and maintain close contact with others that are involved in the direct care of the employee.
Telephonic Case Management
Nurse Case Managers telephonically manage occupational and non-occupational claims and coordinate the employee's return to work. When necessary, they may refer cases for field case management or rehab assignment.
Return To Work
Establishes expectations for early return to work with a clear emphasis on work initiatives. Spooner MCS coordinate the services needed to return employees to the job as quickly and safely as possible, utilizing the best vocational experts available.
Utilization Review
Evaluates whether an employee's medical care including hospital stay, surgery, tests or other treatment is necessary, and meets standards for quality of care. Utilization review can take place before, during, or after the employee receives treatment.
Physician Advisor
Provides advice regarding the medical necessity of treatment, disability duration, and functional ability to return to work.
Provider Bill Review
Spooner MCS audit invoices for accuracy and duplication and adjusts medical bills to conform to mandated fee schedules for both facilities and providers.
MCO Services
Spooner's sister company, Medical Administrators, Inc., is fully certified to provide Managed Care Organization (MCO) programs for employers who require a more packaged approach to disability management.
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