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DocuSign Envelope ID:06CEAA47-F11 F-421A-B8CE-390F42C61208 <br /> SCHEDULE 2-A <br /> Care Advocacy Services <br /> Terms and Conditions <br /> 1. DESCRIPTION OF SERVICES <br /> (a) Care Advocate nurse service("Care Advocate nurse")are provided immediately following <br /> the work injury to guide the claimant's injury recovery, up to 30 days following injury. <br /> The Care Advocate nurses oversee clinical assessment of the injury severity, <br /> validate/secure medical information, act as patient advocates and sets expectations for <br /> medical care and v.They identify the most appropriate treatment and/or most cost-effective <br /> health care alternatives. Care Advocate nurses may confer with the adjuster, attending <br /> physician, other medical providers, employer(s), attorney(s), the patient and the patient's <br /> family. <br /> 2. DELIVERY OF SERVICES <br /> (a) CorVel shall provide Care Advocate Services to Customer upon receipt by CorVel of <br /> specific requests from Customer,however unless otherwise agreed to by the parties,those <br /> cases that meet the Care Advocate referral criteria as mutually agreed shall be <br /> automatically referred to the Care Advocate Service. <br /> (b) Care Advocate nurse service: Care Advocate nurse service includes a four-point contact <br /> with claimant, employer, claims professional and provider. CorVel care advocates do the <br /> following: (i) facilitate communication among all appropriate parties regarding the <br /> diagnosis, prognosis and treatment plan provided by claimant's treating physician, (ii) <br /> channel or direct claimant to a PPO Network provider as appropriate, (iii) monitor and <br /> facilitate treatment planning, (iv) coordinate early return to work, and (v) subsequently <br /> provide periodic assessments of treatment and return to work plans up to 30 days following <br /> the work injury. Care Advocates may recommend additional services or coordinate claim <br /> closure,as appropriate. <br /> (c) Care Advocate nurses are responsible for completing detailed documentation within <br /> CareMC focusing on the claimant's medical condition, treatment plan and return to work <br /> status. Documentation includes but is not limited to primary injury diagnosis, <br /> comorbidities,treatment plan,medical goals,obstacles to recovery,work status and return <br /> to work. <br /> (d) Care Advocate nurses act nurse consultants to the claim team. <br /> (e) Care Advocate nurses act a patient advocates. <br /> (f) Care Advocate nurses assess appropriate medical follow-up, work closely with the claim <br /> team to identify potential barriers to recovery that may require further follow-up or <br /> additional services and develop medical action plans to ensure timely recovery and <br /> restoration of function. <br /> City of Everett,WA—CorVel EC Amendment 3 7-25-2022 <br />