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DocuSign Envelope ID:06CEAA47-F11F-421A-B8CE-390F42C61208 <br /> SCHEDULE 2 <br /> Case Management Services <br /> Terms and Conditions <br /> 1. DESCRIPTION OF SERVICES <br /> (a) Case management services are provided to manage a claimant's case in order to identify <br /> the most appropriate rehabilitative treatment and/or most cost-effective health care <br /> alternatives("Case Management Services"). Case managers may confer with the adjuster, <br /> attending physician, other medical providers, employer(s),attorney(s),the patient and the <br /> patient's family. <br /> (b) In certain states if requested by Customer, Case Management Services may include <br /> vocational rehabilitation services. <br /> 2. DELIVERY OF SERVICES <br /> (a) CorVel shall provide Case Management Services to Customer upon receipt by CorVel of <br /> specific requests from Customer as mutually agreed by both parties under the special <br /> handling instructions. <br /> (b) Telephonic Case Management: Telephonic case management ("TCM") includes a four- <br /> point contact with claimant, employer, claims professional and provider. CorVel case <br /> managers ("CMs") do the following: (i) facilitate communication among all appropriate <br /> parties regarding the diagnosis, prognosis and treatment plan provided by claimant's <br /> treating physician, (ii) channel or direct claimant to a PPO Network provider as <br /> appropriate, (iii) monitor and facilitate treatment planning, (iv) coordinate early return to <br /> work, and(v) subsequently provide periodic assessments of treatment and return to work <br /> plans. CMs may recommend additional services or coordinate claim closure, as <br /> appropriate. <br /> (c) Medical/Field Case Management: CorVel's medical/field case management ("MCM") <br /> personnel perform field based case management services as directed by the employer <br /> and/or Authorized TPA which may include on-site contact with claimant, employer, and <br /> provider, as well as telephonic communication with the claims professional. MCM's <br /> provide the CM services set forth in Section A above. <br /> (d) Vocational Case Management: Vocational case management services may include the <br /> following: (i) coordinating return to work, (ii) providing job analysis, (iii) assisting with <br /> job placement, (iv) providing expert testimony, (v) assisting with job development, (vi) <br /> providing job analysis of essential and non-essential duties for employers under the <br /> American's With Disabilities Act, (vii) providing vocational testimony, (viii) providing <br /> advice regarding job seeking skills,and(ix)providing transferable skills analysis. <br /> (e) Utilization Review: <br /> (i) CorVel's utilization management program reviews proposed inpatient hospital <br /> admissions and ambulatory care to determine the appropriateness,frequency,length of <br /> stay, and setting for such proposed treatment. In addition, CorVel can monitor and <br /> assess the appropriate utilization of treatment for all orthopedic and soft tissue injuries <br /> requiring ambulatory diagnostics and treatment. <br /> (ii) In California, certain medical diagnostics, treatments and durable medical equipment <br /> can be approved at the claims professional level.Utilizing the Adjuster Only Approval <br /> City of Everett,WA—CorVel EC Amendment 3 7-25-2022 <br />