Medical Case Management

Encore Unlimited brings the same high level of intensity, attention, and skill to each case, whether the referral is a task assignment, a typical "3 point contact" referral, or a catastrophic case assignment. Our goals are to resolve the case as quickly as possible while ensuring that all parties receive the services they need to meet their individual goals.

We provide a wide range of case management services including:

• Field Case Management
• Telephonic Case Management
• Catastrophic Case Management
• Medical Appointment Coverage
• Permanent Total Disability Review
• Crisis Intervention Services

Field Case Management
This service encompasses the very essence of our work, face-to-face contact between the Encore Unlimited case manager, the employee, and the employer. All parties benefit from this level of direct interaction in that the employee receives immediate clarification of information and objective support; the customer receives accurate information relative to the employee and the employer now has a resource at their disposal to assist with the return to work process. Through direct communication, Encore Unlimited case managers are able to impact cases positively, striving to provide favorable resolution of all issues.

Telephonic Case Management
We offer distinctive telephonic service for the management of workers’ compensation and non-occupational claims. This service provides for immediate, cost effective contact between an Encore Unlimited medical case manager and one or more of the critical parties involved in the management of a disability claim. Through a customized approach, the telephonic case manager can provide short or long term proactive intervention and assessment.

Catastrophic Case Management
Encore Unlimited medical case managers have an extensive history of managing catastrophic losses such as closed head injuries, severe burns, spinal cord injuries and/or other significant traumas. Many Encore Unlimited case managers maintain the professional certifications critical to our industry. Through a coordinated effort, using telephonic and field case management, a plan is established to reach the optimum outcome. Direction is offered to ensure that the most appropriate medical facilities are being used, at a cost reduced through skillful negotiation. Our medical experts can also offer recommendations surrounding the long-term medical-financial exposure by providing assistance in establishing medical case reserves.

Medical Appointment Coverage
In those instances where limited activity or information is needed, Encore Unlimited case managers stand ready to provide the exact service requested. Be it attendance at one medical appointment, one visit to an employer or the coordination of a second opinion, the Encore Unlimited case manager will deliver the precise service requested.

Permanent Total Disability Review
Once an individual has been deemed permanently disabled, Encore Unlimited’s medical case managers can assist the customer by conducting an annual review to assess current medical status and potential future exposure. This review can include either a home visit or a telephonic interview and will provide exact information relative to the ongoing financial liability and overall health of the disabled individual.

Crisis Intervention Services
Encore Unlimited’s specially trained case managers provide intervention within 24 to 72 hours
following a traumatic incident at the workplace. Our case managers have undergone hours
of crisis training specific to the workplace setting. Early intervention has proven to accelerate
recovery, identify appropriate referrals to qualified mental health professionals and lessen
the harmful effects on the individual(s).

When should you consider a referral to Encore Unlimited for Medical Case Management?

• When a catastrophic injury has occurred.

• When medical guidelines indicate that treatment may be excessive.

• When multiple medical providers have been involved.

• When a definitive treatment plan has not been identified.

• When a "guarded" prognosis has been indicated in medical notes.

• When recovery has been complicated by non-medical issues.

• When there has been a delay in return to work and/or medical recovery.

• When the employee has an unusual disease or disorder.

• When pre-existing conditions or multiple diagnoses have impacted the healing process.

• When communication has been lacking, or diminished by negative attitudes.

• When objective findings are different from subjective complaints.

• When loss time has exceeded 30 days.