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IMPROVING COMMUNICATIONS BETWEEN CASE MANAGERS AND CLINICIANS

December 16, 2022

By Keemia Vaghef, Senior Analytics Consultant

A major challenge for processing claim paperwork is getting the right
information in a timely manner. Case managers working to help patients utilize
their employer leave policies sometimes have to follow-up with healthcare
practitioners’ offices for additional information, especially when extending a
leave request. A follow-up may be for original diagnosis documentation, a change
in diagnosis, or needing a detailed work limitation or restriction plan. With
many medical offices still using older technologies, like fax machines, the
question from case managers persists: how can we improve care delivery with more
efficient communications?

According to a survey conducted by MDGuidelines examining successes and barriers
of case managers interacting with physician offices, 217 U.S. based, short-term
disability case managers identified insights for cases that went smoothly:

 * Providing detailed & easy to understand requests for documentation
 * Utilizing the patient as an advocate to complete paperwork

Additionally, experienced case managers indicated if they could easily provide
data to the clinicians, the most valued topics would include:

 * Common reasons why patients fail to recover
 * The patient’s daily work tasks related to their diagnosis

The research demonstrates that keeping a two-way communication strategy is a key
tool for case managers to improve patient outcomes. Even without a clinical
background, case managers can do the leg work to gather relevant information
that may assist the clinician with their decision making, such as sharing the
patient’s daily expected activities, population-level recovery estimates, or
common non-clinical reasons why healing can be delayed.

Organizations can support building these relationships by:

 * Developing easy-to-use forms with specific instructions for how the form is
   to be filled out
 * Allowing time and training for case managers to add a personal note about how
   this paperwork supports the patient
 * Setting up procedures and protocols for reaching out to clinicians, such as
   fax number phone banks checklists including
 * Integrating access to evidence-based guidelines so that case managers can
   reference the latest information about care

Additionally, survey respondents also had success when including the patient in
the request for information, so the patient was likewise advocating for the
completed paperwork.

These best-practice strategies can help improve communications with physician
offices to ensure that case managers at all levels of experience can streamline
claim progression.

Read more about the survey results in the Case Management Society of America’s
issue of CMSA Today

 

Information provided on this blog is intended for general educational use. It is
not intended to provide legal advice. ReedGroup does not provide legal services.
Consult an attorney for legal advice on this or any other topic.

Tags:
 * Absence Management

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www.reedgroup.com Open in urlscan Pro 52.37.169.148 Public Scan

Form analysis 5 forms found in the DOM

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www.reedgroup.com Open in urlscan Pro
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