How We Help

How We Can Help:

We help to identify candidates for Case Management

Our Registered Nurse Case Managers use data from multiple sources to determine candidates for Case Management which include: Customer Service Phone Calls, Trigger Diagnosis Reporting, Claims Data, Pharmacy Claims Data, and Precertification Reports.

We offer comprehensive Case Management to those identified

Once a member has been identified, our Case Managers provide: Comprehensive Needs Assessments, Discharge Planning, Care Coordination, Discussion and Coordination of Alternative Treatment and Care Settings, Disease Specific Education, Member Health Risk and Disease Knowledge Assessment, and Disease Knowledge Assessment.