Case Management

Case Management

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Our Case Management Program assists the participant and family with issues related to complex medical conditions, recent hospitalizations, unhealthy lifestyles, and high psychosocial risk factors. A distinct advantage of our Case Management program is that, through MAP® and UM referrals, we become involved in cases BEFORE all of the key decisions are made and many of the costs have been incurred. Participants engage with a dedicated Certified Case Manager (CCM), who helps them avoid potential pitfalls.

Services include:

  • Assessment of needs

  • Management of complex medical conditions
  • Review of treatment plans

  • Coordination with providers in the participant’s network

  • Communication with participant, family, providers, and TPA/carrier

  • Review of TPA/carrier reports for CM referrals

  • Referrals to MAP® and MAP® Rx