5 Reasons Field Nurse Case Managers are Worth It

 

First the adjuster needs to gather medical records to determine the patient’s prognosis. Questions the adjuster may ask are: Does the injured worker require an extended hospital stay?  Does the patient have adequate in-home medical care or is an outside vendor recommended? Will the patient require more surgery? These are questions that must be answered, and if the adjuster is unavailable for whatever reason, a field nurse case manager (FNCM) can be very useful in helping to answer these questions. (WCxKit)

 

 

Sometimes in the insurance world, injuries are thought of only in a financial view with short-term glasses rather than total loss costs (less expensive in the long run; greater value.) It is easily forgotten workers sustain serious trauma affecting virtually every aspect of life. These injuries often cause major concern like how does compensation work now? How long will I be off of work? Am I going to be ok? How will I be able to provide for my family?
 

 

These answers are addressed by the field nurse case manager. FNCM workers go to the hospital to visit and talk with the patient and the patient’s family. Or the FNCM meets at the family’s home after a patient is discharged from the hospital. This eases the fear the family may have about the future. The FNCM will have the carrier and adjuster’s contact information as well as other simple, yet comforting information, for the family.  The family’s questions are often medical questions about  the loved one’s injury rather than other aspects.

 

 

An adjuster calls to request medical records, but the request is sent directly to the records department and onto a stack of other requests. However, FNCM are typically registered nurses with advanced medical knowledge and know the paperwork required by the adjuster. This paperwork can include admission papers, doctor’s dictation and transcription, prognosis, diagnosis, diagnostic testing reports, and discharge plans.
 

 

By having someone on-site, the records reach the adjuster quicker. Nurses know how to talk to other nurses. The FCNM knows where to go in the hospital, and who to talk to in order to get this much needed info. Adjusters rely on the ability to get medical records quickly, and the FNCM can accomplish this task.
 

 

If a worker sustains a severe injury, discharge to home can be one of the most complicated aspects. Who is going to care for the injured worker? How will the worker be transported to therapy? Is someone going to help with medication or resuming daily activities? Will  wheelchairs, crutches, shower rails, or a raised toilet seat be needed? 
 

 

The FNCM arrives with a vendor in mind to handle these durable medical equipment (DME) requests. Chances are the adjuster has already authorized the FNCM to select DME the patient needs at home. The injured worker is going to spend a lot of time at home recovering, so proper care is crucial. Several vendors offer various home assistance including but not limited to assistance with meals, food preparation, medication pick-ups, and housecleaning. If an injured worker has no family available to assist, this will ease the fears of being alone. This is the best approach in a life-altering situation.

 

 

The FNCM assists not only with the patient’s initial needs of moving from the hospital to home, but also with ongoing issues and care. If the patient is unable to reach the doctor, the FNCM can address medical questions or meet the patient at the doctor’s office for appointments. Again, it is about being an available resource to the injured worker in the first stages of injury recovery.

 

If the injured workers has chronic pain issues or mental health issues, special FNCM will recognize these issues and assemble a multi-disciplinary team of doctors, psychologists, adjusters pain management specialist, and others at a roundtable to develop action plans with goals and timetables to resolve these problems.
 

 

Psychologically, it can help the worker focus on healing and not on worrying about all the other daily tasks such as picking up medications. Whatever the need may be, the FNCM can make it easier on the injured party by providing resources and assistance.

 

 

A  traumatic serious injury has many questions from all parties involved. The primary concern of the injured worker is to have needs met by the carrier and employer. By setting the claimant up with assistance from a FNCM, it resolves many fears. The goal is to get the worker back on track and focus on healing. The injured worker must not feel neglected in the hospital or at home. By assigning a FNCM, the claimant recognizes the employer is trying to provide the best care possible. The FNCM provides answers to questions, DME assistance, arranges in-home medical care, and seeks to improve the claimant’s daily life especially for injured workers with little family support. (WCxKit)

 

 

FNCM workers have a special job coming to a severely injured worker needing help . They provide assistance in many areas, not only to the injured party but also to the family. The FNCM help the carrier by obtaining much needed information about the injury. They help the employer by providing updates on the injured worker and what to expect medically in the future. Most importantly, the FNCM helps the worker focus on healing by providing quality service that only a nurse can provide.