Preventing Unnecessary Treatment
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Case Challenge #2
The nurse case manager contacted the primary treating physician listed on a new case referral. When she wasn't familiar with the doctor, she asked what type of MD he was. She discovered that he was a psychiatrist. The claim was for a low back injury.

Our Solution
The nurse notified the claims examiner immediately. The examiner did not know the status of the MD. This intervention prevented inappropriate treatment for an orthopedic injury and an indefinite delay in receiving correct treatment.