Third Party Administration

Medical Management

Medical management is key in helping to minimize claims costs and helping injured employees obtain quality health care. What makes AmeriHealth Casualty different is that we have an in-house medical director available to conduct catastrophic case management, in-patient surgical pre-certification, and peer-to-peer review to lead to more positive outcomes.

Our medical management team evaluates the appropriateness of treatment and develops a return-to-work program to help cut-down on unnecessary expenses, such as paying for overtime and temporary help. Through comprehensive review and oversight, our case managers provide prompt, high-quality, and cost-effective medical services to encourage a quick recovery so your employees can return to work.

Our Case Managers Specialize in Workers’ Compensation

Although many insurance companies use medical case managers, ours are registered nurses who are staffed in-house and sit directly next to claims adjusters. What sets our case managers apart is that one is assigned to each lost-time claim. So if your employee is injured on the job and is unable to work, the case manager will oversee that employee’s entire course of treatment.

Our case managers are located in-house enabling them to:

  • work directly with the claimant and claims adjuster;
  • use a supportive approach to help diffuse frustrations and reduce costly litigation;
  • better determine the appropriate course of treatment;
  • more closely track the progress of a claim.

Access to Our Chief Medical Officer

Our medical case managers not only work closely with the claims adjusters, but also with our Chief Medical Officer, Dr. Jennifer Dragoun. She is our on-site physician and a member of senior management who oversees all aspects of medical management, bill re-pricing, and provider relations. One of the medical management program’s greatest strengths is the accessibility and expertise of Dr. Jennifer Dragoun. She is available personally to meet with you, help implement initiatives/special handling instructions, provide peer-to-peer discussions with providers, and help ensure high-quality medical care and significant medical savings.

Want to know more about AmeriHealth Casualty? Email us or call 1-800-335-5972.