Next Step Medical Advisory ProgramSM is a collaborative approach utilizing senior EK Health physicians, nurses, legal consultants and project coordinators to provide a comprehensive review and recommendation on the most complicated and costly cases and move them to closure and settlement. At a minimum, Next Step involves an in-depth file review, round table discussions with all stake holders, and peer-to-peer physician communication.
It is a team effort to impact a case and move it to closure and settlement. Working closely with the claims examiner, treating physician and applicable parties, the EK Next Step team assists to get the case on track with prescribed medications and medical treatments in relation to evidence-based medical guidelines.
Why Refer a Case to Next Step Medical Advisory ProgramSM?
To benefit from case examination by trained professionals in collaboration with the Primary Treating Physician to prevent inappropriate medical care, insure care is focused on MMI, and avoid paying for treatment unrelated to the injury.
Applicable Case Types:
- Prolonged TTD > 1 YR.
- Medical costs > $25,000.00
- Unanticipated Medical care & costs beyond original injury
- Long term cases with no expected closure date
- Catastrophic Cases
- Chronic Pain Cases (CRPS)
- Prescription costs > $500.00/month
- Multiple Providers
- Chronic Complex Conditions
- Escalation of Treatments Costs and Body Parts
- Poly Pharmacy / Poly Substance Abuse
Chronic Pain Cases Defined As:
- Pain is considered chronic if it persists longer than expected after an illness or injury.
Catastrophic Cases Defined As:
- Spinal Cord Injury
- Traumatic Brain Injury
- Burns- Thermal, Chemical, Electrical
- Multiple Trauma / Fractures
- Complex Chronic Conditions