Case Management
Case Management Program

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