1010 E. Union St. Suite 203, Pasadena, CA 91106 P: (866) 808-GSGA
Banner_right
Early Intervention Medical/Disability Management

GSG’s unique program combines early communication with providers, utilization review for inpatient and outpatient services, network channeling, medical case management and early return to work by the GSG nurses "assigned" to the account. The assigned GSG nurses can be placed in the claims department on the employer’s premises to facilitate communication or work from GSG's Corporate Headquarters.

How it works:

  • The process begins with the GSG nurse’s review of new reports of injury or cases.
  • Treatment plans are reviewed to corroborate with approved guidelines.
  • Reports that indicate lost time or specified ongoing treatment are established as actual work files by the GSG nurse.
  • The GSG nurse consults with treating doctors regarding appropriate treatment plans and negotiates treatment plans to industry best practice standards. The nurse follows up on a regular basis to assure that the employee is progressing with the prescribed medical treatment.
  • The GSG nurse immediately contacts the treating doctor to establish the abilities(restrictions) of the employee post-injury and coordinates a return to transitional tasks with the employer, doctor, employee and adjuster.
  • Inpatient and outpatient tests, surgeries and therapies are reviewed to determine medical appropriateness and necessity utilizing guidelines. Pre-certifications are given when medical necessity is established. Authorized treatments are channeled to networks where applicable and allowed by statute.
  • The adjuster always maintains control of the claim. The GSG nurse works with the claims staff as a team member.
  • To show a significant decrease in unnecessary spending on the medical portion of an open claim as well as to significantly reduce temporary disability (TD) and permanent disability (PD) costs.
  • To reduce lost time/days away, resulting in a decrease in the associated costs of substitute employees, overtime and lost productivity.
  • To ensure the employee is following a path of “appropriate treatment from the appropriate provider at the appropriate time” that will lead to earlier return to work and medical resolution.

Back to top

banner_right