Case Management

University Hospitals CompCare is a wholly owned subsidiary of University Hospitals Health System. We provide comprehensive case management services to Ohio injured workers whose employers have selected UCC as their MCO. Our mission is to provide exceptional customer service in the management of care for these injured workers, and our case management program works to support that mission. Services promote the rendering of high quality, cost-effective medical treatment that focuses on minimizing the physical, emotional, and financial impact of a work-related injury or illness and promotes a safe return to work.

Case management is a process to assess, plan, implement, coordinate, monitor and evaluate care along the health care continuum, by collaboration with the injured worker, employer and physicians treating the injury. We meet the health needs of injured workers through communication and the use of available resources to promote quality, cost-effective outcomes. Our case managers assess the needs of each client. Then an individualized plan is developed to assist in coordinating appropriate and necessary treatment and services. The process incorporates the use of medical criteria, guidelines and claim allowance criteria. The case management staff may seek available alternative services tailored to meet the injured worker's individual needs.

University Hospitals CompCare's medical case managers are all registered nurses and/or certified case managers. Using a team approach to service, each case manager, along with a Customer Service Representative and a Billing Representative, is assigned to specific employers to enhance the development of a relationship and better understand employer specific needs. UCC case managers are available for interaction with employers, injured workers and health care providers.

University Hospitals CompCare solicits feedback and suggestions from all partners in the continuum of care, via surveys and direct contact. Our aim is to continuously improve our product, and you are our most important customer.

We Are URAC-Accredited

University Hospitals CompCare has earned Case Management Organization full accreditation by URAC. The most recent two-year accreditation by the premier organization for accreditation of case management services is effective through 2007.

URAC accreditation signifies that University Hospitals CompCare has all of necessary policies and procedures in place for medical case management and that they are applied consistently. We create case management plans for injured workers that set short- and long-term goals, and we are committed to the confidentiality of client-specific information. For more information about URAC's accreditation criteria, visit www.urac.org.

Case Manager Responsibilities

The job of the medical case manager is fourfold:

• Facilitate communication among parties to the case to ensure prompt, effective treatment, rehabilitation and return-to-work.
• Serve as a peer to health care providers, and help employers and injured workers understand the medical management process.
• Review requests by providers to perform certain medical procedures.
• Work with Ohio Bureau of Workers' compensation claims specialists regarding claims determination and medical treatment.

The case managers combine their medical and case management experience with site visits to understand how specific workplaces operate and how injuries can be prevented. Beyond that, they are skilled communicators trained to help employers and employees cope with the frustration and anxiety associated with workplace injuries.

Return-to-Work

The ability to get people back to work quickly and safely is one of the most important parts of a case manager's responsibilities. If a provider believes an injured worker can return to work in an alternative job, case managers work with all parties to identify transitional-duty jobs and tasks that can be done safely until the worker is fully recovered. Early return-to-work impacts case resolution, decreases lost time, controls medical expenses and lessens the employer's risk.