OMCA's medical case management goal is to facilitate quality care, appropriate specialty referral, optimal recovery and appropriate return to work for employees sustaining a work injury. The Nurse Case Manager utilizes medical management guidelines to assess, coordinate, monitor and evaluate a provider's plan of care for the injured worker.

The earliest possible return to work is expedited by timely communication between the injured employee, employer, adjuster and physician. Identification of modified duty, temporary alternative duty and requirements under the Americans with Disability Act are kept in mind while working together to achieve the earliest reasonable return to work for the injured employee.

Communication is a key element for successful medical case management. OMCA will tailor communication protocols to the needs of the employer, TPA, or insurance carrier. Timely communication by phone, e-mail, fax, or by written report is essential for a successful recovery and return to work of the injured worker.

OMCA medical case managers will work with treating physicians to develop and implement a treatment plan for the injured worker. The plan will be reviewed and modified as the patient progresses in the recovery process.

Medical case managers monitor the progress of each injured worker to insure they are moving toward maximum medical improvement. Patients will not be allowed to treat ad infinitum with a physician if no improvement is seen. They will be referred to a specialist to maximize their rate of progress.

Case managers monitor treatment for the workplace injury to ensure that it is compatible with any treatment the patient may be getting for other medical issues.

Adjusters are notified of case management activity within 24 hours or less. Issues such as MMI (Maximum Medical Improvement) and a change in work status are communicated to the adjuster the same day as they are received.