Last summer, a nasty dog bite sent Beth* to the emergency room close to her home in Pennsylvania. The doctors there diagnosed her with compound fractures in her left hand and referred her to an orthopedic surgeon. Distraught when the surgeon advised that her finger would need to be amputated, Beth sought a second opinion. By the time she reached another doctor to schedule a follow-up, nearly one month had passed since the injury. She was told that the out-of-network doctor who would provide a second opinion did not have availability for another two weeks. Beth was referred to PHSO to help manage her care.
Her pain was not getting better, but Beth’s prognosis was about to improve significantly.
Just five days after the case manager contacted her, Beth had an appointment with an in-network orthopedic surgeon at UM SJMC. The surgeon assured her that not only was amputation not necessary, the injury would not require surgery at all. The wound was healing nicely, and a simple splint would help the fractures mend. Beth was able to return to her job as a data entry technician within the System sooner than anticipated, and thanks to the case manager identifying an in-network doctor, the cost of her treatment was less than she thought it was going to be.
UM’s PHSO is using medical management like Beth experienced to support the overall health of our employees, reduce unnecessary cost and enhance the quality of our health care experience.
*Not her real name.