Upon referral to Novare, the account/referral source can send records via a secure drop box. Upon receipt of the referral information/records the adjuster is notified and given the contact information of the field case manager. After review of the referral and records, the field nurse case manager contacts the adjuster by the end of the next business day to discuss and confirm instructions. The claims adjuster will be asked to approve all services and on-site visits, and the adjuster will adhere accounts special instructions.
Initial and follow up reports may include, but are not limited to:
- A brief summary of medical history
- A brief vocational history to include job demands of job held at time of injury
- A confirmation of work status (for example, no work, working modified duty)
- Document availability of transitional work and attempt to obtain specific medical activity restrictions vs. “light duty” reference guidelines such as Medical Disability Advisor (MDA) or Official Disability Guidelines (ODG), physician’s anticipated length of disability
- Case management plan with goals and reevaluation – if barriers are identified, are solutions developed?
Novare staff average years of experience in Workers’ Compensation medical cost containment is as follows:
- Leadership and Managers – 17.5 years
- Medical Auditing Staff – 7 years
- Utilization Review Nurses – 14.5 years
- Technical Support – 7.5 years
- Clerical staff – 8.5 years