Medical Management

Broadspire’s case managers proactively manage medical treatment while facilitating understanding of, and participation in, the rehabilitation process. These programs aim to help employees recover as quickly as possible in the most cost-effective method.

Medical Management At-A-Glance

More than 180 field nurses and vocational experts and more than 35 telephonic nurses
Compassionate, professional team with extensive experience and credentials
Access to the most current information about treatment, healthcare and rehabilitative techniques
Proactive management that focuses on abilities and results
System integration with claim adjusters
On-site physician advisors and on-line medical resources
Flexible program offerings
AAHCC/URAC accreditation for quality

Medical Management Services

Service	Overview
Broadspire Care Management	Needs assessment of elderly, disabled or chronically ill persons to determine best options and actions.
Durable Medical Equipment (DME) Formulary	Apply cost management to DME to both meet the medical needs of injured employees and reduce overall cost of DME.
Medical Bill Review	Evaluation of surgical, medical, hospital and pharmacy bills to help eliminate unwarranted charges.
Comprehensive Pharmacy Management	A nationwide prescription program with first script fill, non-formulary review and drug utilization monitoring with automatic referral of outliers.
Utilization Management	Advisors help claim technicians successfully manage medical aspects of claims.
Medical Department and Physician Review Services	Medical team clinical and analytical expertise to support case management programs.
Senior Nurse Reviewer	Helps disabled workers receive proper attention for a speedy recovery.
Telephonic Case Management	Support and quality assurance from medical resource consultants.
Field Case Management	Customized packages for planning, evaluation, management and rehabilitation services.

Our goal is to facilitate appropriate treatment and promote cost-effective solutions. Contact us.