Medical Case Management
The purpose of the Medical Case Management Program, or Case Management, is to help coordinate the medical treatment services provided to injured employees for their work-related injuries. This is done through a case manager that assists in facilitating medical care.
Is Case Management Required?
No. Employers or insurance adjusters may, at their own expense, utilize case management but it is not required. If utilized, injured workers must cooperate with the case manager.
Elements
Case Management services shall include, but not be limited to:
- Developing a treatment plan to provide appropriate medical services;
- Monitoring the treatment and medical progress;
- Assessing whether medical services are appropriate and delivered in a cost-effective manner, based on acceptable medical standards;
- Ensuring that the injured employee is following the treatment plan
- Formulating a plan for return to work, with due regard for the employee's recovery, restrictions, and limitations, if any.
Frequently Asked Questions
These FAQs explain the rules and requirements for case managers such as registration requirements, renewal fees, and providing proof for specific continuing educational units.
Register as a Case Manager
Case managers are employed by the insurance carrier as they coordinate the medical diagnostic and treatment services provided by the authorized treating physician to the injured employee.
Case Managers must register with the Bureau prior to providing services involving Tennessee Claims.
Application for Case Manager Registration
Registration may be faxed to (615) 253-5265, submitted by email to wccase.management@tn.gov, or mailed to:
Attention: Medical Case Management Coordinator
Bureau of Workers' Compensation
220 French Landing Drive, Suite 1B
Nashville, TN 37243
Submit Forms via Online Portal
Please use the portal to submit all case management forms:
- Form C-33 (Case Management Notification)
- Form C-34 (Case Management Closure)
For questions or issues accessing the online portal, call 615-532-1325 or email wccase.management@tn.gov.
Case Management Closure Instructions
The closure form is to be completed by the case manager upon the conclusion of the case management assignment. Every field must be completed including the physician's license number. The proper ICD 10 code should be used for each diagnosis, and the five digit AMA CPT code should be used for each procedure.
Closure Codes
- RTW Employee has returned to work successfully.
- RRW Employee has been released to work, but did not return to work.
- MMI Maximum medical improvement obtained.
- SP Employee has not yet returned to work, but is making satisfactory progress.
- CD Employee deceased.
- NC Case Manager is closing case without significant progress by employee.
- CR Closed at adjuster's request.
Questions? Email wccase.management@tn.gov.
Training for Case Managers
Attention Case Managers! We would like to partner with you in informing injured workers about the Next Step Program. This training teaches case managers how they can help injured workers best utilize the resources, funds, and expertise of the Next Step Program. This training will be delivered online via Microsoft Teams.
- Online, Free
- Date: Fall 2024 (TBD)
- Available Credit: 1 CEU (Commission for Case Manager Certification)