Medical Case Management

Information Applies to Utah Claims 

Medical Case Management (MCM) is a service offered by WCF Insurance to our catastrophically injured workers or for claims that are medically and psychologically complicated.  Our medical case managers are all registered nurses certified in rehabilitation and/or case management.  They provide on-site coordination of care for the injured workers and communicate with the medical providers to establish treatment plans and to help facilitate optimal functional outcomes.  

  1. Our MCM’s meet face to face with the injured workers in their homes, health care facilities and at medical provider appointments and they serve as important facilitators among the injured worker, family, claims adjuster, treating providers, health care team and the community.  
  2.  While there are many definitions of case management, the WCF Insurance medical case managers support the Case Management Society of America definition:  Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality cost effective outcomes.  
  3.  The MCM’s will attend physician appointments with the injured worker to stay current on the treatment plan and the progress towards recovery, and assist in the coordination of recommended treatment.  The WCF Insurance MCM’s always adhere to the Labor Commission Rule 612-300-2-G-Injured Worker’s Right to Privacy (www.laborcommission.utah.gov)
  4. Not all WCF Insurance injured workers are assigned a medical case manager.  Physicians may request the services of an MCM to assist with coordination of care by calling one of the contact numbers listed below.   

Important Contact Information:
Chelia Walkenhorst, RN, CRRN, CCM
AVP, Medical Management and Rehab
385.351.8151
cwalkenhorst@wcf.com

J.D. Ashby
VP Claims
385.351.8301
jdashby@wcf.com

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Insurance coverage in all states other than Utah is provided by Advantage Workers Compensation Insurance Company, a wholly-owned subsidiary of WCF Mutual Insurance Company, doing business as WCF Insurance. Advantage is domiciled in Indiana; NAIC number: 40517. Administrative office: P.O. Box 571918, Salt Lake City, UT 84157-1918.
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