CSG's Managed Care Division/Workers’ Compensation is managed by a clinical team whose experience focuses on case management certification, workers’ compensation and longevity within CSG.

Upon receipt of First Report of Injury (FROI) the claim is assigned by a case management supervisory staff member to Triage; Med Only; Lost Time; or FCM staff according to claim information provided and CSG established criteria. Care will be directed to a network provider in accordance with State WC Regulations.

All files referred to CSG for case management will begin with a review of the file along with existing medical records.

The case manager will make a four-point contact (injured worker; treating provider(s); employer; and adjustor). An individualized case management plan is completed after completing an initial assessment and reviewing the treating provider(s) office notes. The case management plan is updated after each provider visit.

The treatment is continuously monitored by the nurse assigned to the claim to assure that it complies with our standards of care. Standard case management plans and procedures are based on clinical criteria developed by the Medical Disability Advisor (MDA) Guidelines. When hospitalization or surgical procedures are required, Milliman Care Guidelines may be referenced.