Case Management
At Ophilayo Case Management, we specialize in managing all post-settlement needs for beneficiaries once funds are placed in trust. Collaborating with special trusts, our goal is to ensure beneficiaries are not just supported but empowered to lead fulfilling lives. We prioritize care and solutions that enable them to thrive rather than merely survive, fostering a lifestyle that promotes independence, dignity, and well-being.
Personalised Care Plans
Ophilayo Case Management
Assessment and Evaluation
We conduct detailed assessments to understand each patient's specific needs and goals, ensuring personalised care plans.
Coordination of Care
We manage all aspects of care, including scheduling medical appointments, and therapy sessions, and procuring necessary equipment
Therapy and Treatment Management
We oversee the implementation of therapies and treatments, ensuring effectiveness and making adjustments for optimal outcomes
Medical Device and Aid Procurement
We assist in identifying, procuring, and ensuring the proper use of medical devices and aids essential for patient well-being.
Due Diligence Services
Our meticulous due diligence verifies that medical recommendations align with funding and meet patient needs.
Ongoing Monitoring and Analysis
We continuously monitor patient progress and analyse intervention effectiveness, making adjustments as needed for optimal outcomes.
At Ophilayo Case Management, our mission is to provide comprehensive, compassionate support that empowers patients to achieve their maximum potential and improve their quality of life.
Ophilayo employs over 40 case managers located across all 9 provinces of South Africa. Our extensive network ensures that no matter where you are based, we have a dedicated case manager ready to assist you.
Services
For Legal Professionals
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Prioritising Immediate Needs
We promptly address urgent requirements to ensure the Claimant's immediate needs are met effectively. -
Quantifying Claims
Ophilayo supports the quantification of claims by providing thorough assessments and documentation crucial for interim payment applications. -
Implementing Recommendations
Once funds are available, our Case Managers diligently implement recommendations from Medical Legal Reports and Court Orders. This includes coordinating therapies, treatments, and necessary medical devices to support the Claimant's recovery.
For Funders & Trustees
Ensuring Intended Usage
We ensure funds are allocated for their intended purposes, overseeing expenditures to align with beneficiaries' medical and therapeutic needs.
Mediation and Communication
Acting as mediators, we facilitate effective communication among funders/trustees, beneficiaries, and their families, addressing demands and needs efficiently.
Cost-Effective Spending
We prioritise prudent spending in line with available funds, optimising resources for maximum impact and longevity.
Safeguarding Fund Longevity
Collaboration with stakeholders aims to safeguard funds for sustainable support over time.
Motivated and Justified Spending
All fund expenditures are meticulously motivated and justified, ensuring transparency and accountability.
Professional and Reliable Services
Ophilayo offers professional, flexible services tailored to the unique needs of each beneficiary and their support network.
Through our intermediary role, Ophilayo streamlines fund management processes enhances communication and ensures efficient resource utilisation to support beneficiaries’ well-being effectively.
For insurance companies
Ophilayo acts as a crucial intermediary, meticulously monitoring insurance cases to validate the necessity, reasonableness, and legitimacy of all claims and expenses. Our goal in Insurance Case Management is to assist all parties involved, ensuring proper utilisation of insurance company funds while prioritising the claimant's care. With our comprehensive approach, we promote transparency, accountability, and fairness throughout the insurance claims process, ultimately fostering the well-being of insurers and claimants alike.
For Beneficiaries and Families
At Ophilayo, our case managers act as central coordinators, ensuring alignment among all stakeholders—family, caregivers, trustees, attorneys, and doctors—to prioritise the beneficiary's needs and best interests. By fostering open communication channels between the Trust, legal professionals, and the beneficiary, allocated funds are effectively utilised to enhance quality of life.
Our case managers play a crucial role in identifying and implementing tailored solutions for individual needs, encompassing a comprehensive range of services outlined in the accompanying diagram. These services are designed to address various aspects of the beneficiary's well-being, ensuring holistic support and optimal outcomes.