Case Management is a widespread program for controlling the escalating costs of serious illnesses and/or chronic diseases. It assures that the medical services being paid are essential, effective, and being delivered in the most appropriate, coordinated, and cost-effective manner available. Case-management criteria varies depending upon the patient's diagnoses, chronicity or severity of illness, particular needs, and/or costly treatments involved in the patient's care.

Our Case Management Program provides the following services:

• Assesses appropriateness and medical necessity of care

• Assesses the needs of the patient and family

• Provides compassionate, personalized assistance

• Coordinates care with medical providers or facilities

• Identifies available resources in the community

• Assists patient in understanding his/her medical condition

• Assists patient/family in appropriate medical-care decisions

• Represents our client (the group) as a qualified and objective third party

• Provides nationwide coverage

• Arranges price negotiations with out-of-network providers

• Helps resolve claim issues