Inside Workers’ Comp Blog

Six Ways TCMs Are Crucial During COVID-19

Posted by Dawn Moore on April 9, 2020

Telephonic Case Management:  Always Putting the Injured Worker First

Our telephonic case manager (TCM) team is constantly communicating best strategies to move claims forward during the pandemic. I’ve synopsized these efforts based on real cases in which case managers have been asked to go the extra mile in helping injured employees receive necessary care during this difficult time.

  1. Coordinating care. Telephonic case managers are charged with assisting providers with treatment options if they are unable to see injured employees in a clinical setting. This has become extremely important over the past few weeks with the challenges of social distancing. Treatment delays can lead to more complex claims and recovery regression for injured employees. Our case managers have been instrumental in moving appointments providers or injured employees may have cancelled or postponed due to isolation restrictions to telemedicine visits, ensuring injured employees are receiving the care they need. We have worked closely with providers in setting up teleconferencing office visits, physical therapy sessions and follow-up visits.
  2. Accommodating high-risk injured employees. Our case managers are connecting more frequently with older injured employees and those with compromised immune systems to ensure they’re following COVID-19 prevention protocols. While the pandemic is tenuous for everyone, the high-risk set have an added layer of concern — how best to protect themselves from illness. We’ve increased our telepresence usage to enable face-to-face connection and offer more empathetic interaction and genuine reassurance when the injured employee can see the case manager advocate on the other end of the line.
  3. Keeping employees safe.Through ongoing training using the most current COVID-19 CDC guidelines and proprietary Genex Coronavirus/COVID-19 Clinical Guidelines, our case managers continuously educate injured employees on how best to protect themselves while attending provider appointments or carrying on activities of daily living. This includes offering guidance on how to best maintain social distance in waiting rooms, such as calling the front desk upon arrival in the parking lot and asking them to call when the provider is ready to see them so they can stay in their car to avoid possible exposure.
  4. Managing cancelled appointments. Injured employees who have had elective surgery or other procedures postponed or cancelled due to coronavirus restrictions may be dealing with anxiety and uncertainty. It is imperative they do not become despondent or stagnant in their current health routines. Telephonic case managers are helping these individuals continue their exercises, sometimes through teleconferencing, and are educating them on the importance of maintaining health so they are prepared, mentally and physically, to receive surgery as soon as it can be rescheduled.  
  5. Providing psychosocial support. Injured employees typically experience varying levels of angst when recovering from a work-related injury. These include concerns about recovery, job security, financial uncertainties and whether they’re receiving the most appropriate care. The COVID crisis has added an additional layer of anxiety as individuals deal with stress of cancelled appointments, maintaining safe distancing while receiving care and increasing job layoffs and furloughs. This is where case managers serve as a critical connection in helping reduce anxiety through education, and addressing concerns related to access to care, employment issues and treatment protocol. By easing these fears and providing an empathetic ear, the TCM can help the employee maintain a positive mindset about his or her recovery and ensure compliance with the regimen.
  6. Facing COVID head-on. We are aware of employees being tested awaiting testing for COVID-19. Telephonic case managers are charged with staying in close contact with these employees to confirm they follow through with getting their results, adhering to COVID-19 CDC guidelines and proprietary Genex Coronavirus/COVID-19 Clinical Guidelines maintaining communication between patient and providers.

Dawn Moore, RN, MSN, CCM, is Western Region Case Management director at Genex.


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