If you sustain an injury at work, you may have a nurse case manager appointed to your case. Many of our clients are unaware of the role of a nurse case manager, and many of them have never even heard of one until they begin their workers’ compensation case.
But who are nurse case managers, and should you trust them? They say they are helping you get the best medical outcome — but could there be any other motives for their involvement in your health care?
In this article, we’ll discuss who Nurse Case Managers are and explore if they truly have our best interests in mind.
Who are Case Managers?
Nurse case managers are registered nurses who specialize in coordinating patient care. Their primary role is to assess, plan, coordinate, facilitate, and monitor the provision of healthcare services that meet a patient’s needs during treatment. They are also responsible for maintaining detailed records of all aspects of patient care.
In their role as Nurse Case Manager, they collaborate with other healthcare professionals to provide optimal patient care throughout the clinical journey of a hospitalized or medically ill patients. They monitor the progression and status of a patient’s medical condition and adjust treatment plans accordingly. Moreover, they provide education and support to both patients and families.
Their duties can range from medication management to providing resources for community-based services such as home health aides or physical therapy when necessary. They continually assess changes in the medical condition, document progress notes in the medical record, and communicate findings among the multidisciplinary team (MDT).
Are Nurse Care Managers on Your Side?
A nurse case manager is a neutral third party in your case. They don’t work for the insurance company, nor are they a part of your medical team. It is their job to report information on your condition to the insurance carrier, the hope being that doing so will speed up your case.
Nurse case managers are also responsible for helping ensure that you get the best care possible. They can provide guidance and advice on how to access resources that may benefit your health and recovery. They can help coordinate care with other providers, make sure your medical bills are paid, and ensure that you have all the necessary information about your case.
They also work to keep communication between you and your medical team going. In short, they can be a great resource for you as you navigate the workers’ compensation system.
Can you completely trust your nurse case manager?
Can you completely trust your nurse case manager? Ultimately, it is up to you to determine if you feel comfortable trusting a nurse case manager. While they may have your best interests in mind, some of their actions may be motivated by the insurance provider’s desire to limit costs and minimize legal liability.
It’s important to understand that a nurse case manager is supposed to be objective. Everything you say to them will be reported to your insurance provider. Therefore, be careful: Don’t say anything that could be misconstrued or harmful to your case. We recommend looking over all of the notes that your nurse case manager passes along, and make sure to dispute any discrepancies. You should be receiving copies of these notes. Moreover, your nurse case manager should not be speaking to your doctor if you are not present.
If you feel that your nurse case manager is acting in a way that is harmful to your case, or representing you in an unfair light, be sure to contact an experienced attorney to help you negotiate with them. You should always tell your attorney if you feel that your nurse case manager is not protecting your rights (for example, if they are not providing you with copies of their correspondences or attempting to speak with your doctor without your presence).
