This session explores how utilization review impacts treatment decisions and the role of nurse case managers in coordinating care for workers’ compensation claims. Learn key regulatory requirements, communication best practices, and strategies for effective medical management that balance cost and quality. The session also covers handling conflicts between UR and treating physician recommendations, including appeals and 19(b) options.
Originally presented as part of Workers' Compensation Institute 2026.
Credits: 0.75 General, 0 Diversity/Inclusion PR, 0 MH/SA PR, 0 Other PR
Expires 03/01/2028
This session explores how utilization review impacts treatment decisions and the role of nurse case managers in coordinating care for workers’ compensation claims. Learn key regulatory requirements, communication best practices, and strategies for effective medical management that balance cost and quality. The session also covers handling conflicts between UR and treating physician recommendations, including appeals and 19(b) options.
John J. Castaneda, Castaneda Law Office, Geneva
Jaclyn D. Jednachowski, Rusin Law, Ltd, Chicago