Case Management
Studies have shown that large claims associated with catastrophic illnesses, account for over 80% of medical expenditures for Employer Health Plans. During these times of escalating medical expenses, employers are looking for ways to save claim dollars. Medical Case Management has proven to reduce paid claims substantially, when instituted early, in potentially catastrophic illnesses. Our Case Managers are all registered nurses with extensive clinical experience in a multitude of medical specialties. Our nurses have achieved the Certified Case Manager (CCM) designation.
Commission for Case Management Certification
Case Management Role Functions:
- Assess and plan
- Facilitate and coordinate physician orders
- Implement the treatment plan
- Educate and train patients and family members
- Negotiate discounts for services
How Case Management Can Save Your Life, click here >>
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Centers of Excellence for Transplants WellChoice, Inc. is committed to controlling costs for catastrophic claims. Organ and tissue transplants are among the highest dollar claims. In order to help our clients control and limit their expenses, we are able to access a Centers of Excellence Network for Transplants. By utilizing the transplant network, our clients can contract for global fees (case rates) for the actual transplant and discounts for pre and post transplant care for up to one year after the transplant. By contracting for case rates, the employer limits his liability and is able to predict and project the costs for his potentially high dollar claims. |
