Effective Solutions When You Need it the Most
Heartland Care Management's Professional Case Managers interact with injured workers, providers, and employers to provide the services needed to return the clients to work in a safe and timely manner.
Medical Case Management
Recommended Treatment Plans For Appropriate Medical Care
HCMI utilizes seasoned case managers that consistently demonstrate our ability to provide outstanding, cost-effective, comprehensive case management services. The case management of an injured client requires professional specialization and commitment to credible and ethical standards. The HCMI case manager is in a unique position to act as the liaison among the injured party, the employer, the attending physicians, the referral source, other health care providers, the attorney, and other involved agencies. From this vantage point, he can be extremely instrumental in providing an overview of the client's total situation and in assisting all involved parties to understand the client's overall situation. Furthermore, his involvement offers a positive focus for a client who may feel fragmented by many different people, each offering different, and sometimes conflicting, services.
Utilization Review
Review of Requested Medical Treatment
Healthcare utilization management is a process for evaluating medical care efficiency. The case manager identifies appropriate levels of care and considers alternative therapies and resource usage. To measure improvement in medical care efficiency, the practitioner presents care providers with specific opportunities to improve and monitors their progress over time. Heartland Care Management Services, Inc.'s (hereafter referred to as Heartland) utilization review program is currently fully staffed and operational. Heartland's home office, located at 88 Commerce Blvd, Benton, KY, oversees all aspects of the utilization review program for K.Y. and T.N.
Life Care Plans
Projected Lifetime Cost of Care Due to Catastrophic Injury
Life Care Plans are a comprehensive, systematic method to determine the individual care needs and related costs for someone who has experienced a catastrophic injury, accident, or chronic illness. Developing the Catastrophic Life Care Plan entails an expert examination of all available, pertinent resources basing the needs on the Projected Life Expectancy of the injured individual. The HCMI Life Care planner is able to meet directly with the individual/family for whom the plan is prepared, review all pertinent medical records, therapy records, school/educational records, and vocational records, which are key contributory elements in a credible Life Care Plan. Approaching the Life Care Plan process from the holistic nursing and social work perspectives, HCMI is able to capture both the factual data and the case nuances to assist attorneys, employers, adjusters, and others in their work towards appropriate and equitable results.
Catastrophic Case Management
Customized Plan of Care for Patients With Complex Diagnoses
HCMI's catastrophic program provides an immediate response by a catastrophically trained on-call FCM* 24 hours a day, in the event that an individual sustains a catastrophic injury at any time. These case managers will travel onsite as needed and are prepared to provide telephonic and field medical case management as appropriate until a treatment plan is established. Upon receipt of the referral, the case manager must make immediate contact with the referral source, client/family, and facility to determine the client's status, provide support to the family, and develop an immediate plan of action for the case. In many situations, this will involve same or next day travel onsite to the treatment center to begin the case management process. A catastrophic injury requires an immediate response. The client's best chance for survival and ultimately an optimal recovery depends greatly upon the quality of care he or she receives immediately post-injury. The services offered during the initial phase of HCMI's catastrophic case management program are designed to respond to the immediate needs of the newly injured individual - family.
