Potential Clients

What do case managers do?

Our case managers:
  • Create a plan of care that accounts for all aspects of care the injured client needs
  • Advocate on your behalf with insurance adjusters
  • Educate you about your diagnosis, including dealing with TBI and SCI
  • Manage the medical and rehab process
  • Help the transition to different care levels as able to progress through he rehabilitation process
  • Schedule appointments: coordinate transportation and attendant care
  • Accompany you to appointments, and explain what is happening to you, your family and significant individuals involved in your rehabilitation.
  • Arrange for and manage medical equipment needs
  • Communicate between doctors, family needs, and providers. So you can focus on your recovery

Why should I use case management services?

Case management services save time, money, and effort, while helping you obtain the most skilled services for your specific condition. Case management helps you gain access to the most appropriate and qualified medical providers. Case management contains costs by implementing the most appropriate course of action to expedite the rehabilitation process. Our case managers work for you, so that you can focus on your rehabilitation and recovery.

When are the services of a case manager needed?

There are numerous circumstances in which case management services are needed, including:
 
a. When an individual is living with a chronic condition that severely affects their functional ability and quality of life
 
b. When an individual has experienced a catastrophic injury (brain injury, spinal cord injury, or neurological disorder) as a result of a motor vehicle accident or work related accident
 
c. When an individual is no longer able to live independently due to the effects of injury, illness, or aging
 
d. When there is a noted lack of progress in an individual's recovery from an injury, condition, or diagnosis
 
e. When a physician recommends a course of treatment including medical procedures or surgeries, and the individual is unclear as to what choices are best fo them
 
f. When an individual is discharged from the hospital after multiple injuries or servere injuries without a clearly defined rehabilitation plan
 
g. When multiple health care providers are involved in an individual's complex treatment resulting in lack of coordination in care and communication
 
h. When an individual is taking numerous medications prescribed by different physicians and there is concern regarding overlapping side effects.
 
Case management services are not limited to the above circumstances. Please contact us to confirm whether we can be of service to you and your particular situation.

Who can retain the services of a case manager?

Case management services may be retained by: the individual themselves, their family, an attorney or guardian, an insurance company, employer, or employer's representative.

What if there is an insurance or hospital case manager already there – what can I do?

You have the right to select your CM. A letter can be written by the patient, legal guardian or family member telling the insurance company that a new case manager has been selected by the patient.

How is Kalous Case Management paid?

Case management services are a benefit provided under Michigan’s Auto No-Fault Law. Workers Compensation has case management as a benefit as well. Your case manager will bill the insurance of priority which can include auto Insurance, workers compensation or private pay.