Case Management
Tangible Results
Healthier Lives. Primary PhysicianCare incorporates comprehensive case management as part of our fully-integrated approach. With 20% of the work population accounting for 80% of total healthcare costs, case management is a crucial tool for monitoring the care of patients with the most complex and catastrophic medical conditions. The results are tangible:
Our clients save an average of $20 for every $1 spent on our case management services.
Our Role
Knowledgeable Liaisons. Primary PhysicianCare’s knowledgeable case managers serve as liaisons between patients, physicians, specialists, insurance companies and employers to ensure the delivery of high-quality care within realistic cost-containment strategies. In addition, they evaluate and coordinate treatment progress to make sure patients continue to receive the most cost-effective care for their individual needs. Here is a small sample of the services provided by our case managers:
- Secure proper medical care and equipment
- Prevent inappropriate or excessive treatment
- Coordinate and provide necessary follow-up treatments
- Inform insurance companies about illnesses and treatments
- Expedite facility/home placement and care
- Help patients find community resources
- Help families understand and adjust to conditions
- Provide counseling, guidance and support to patients and their families
Benefits Analysis
Personal Attention. Primary PhysicianCare offers case managers, staff and consultants who are experienced in managing critical care, insurance plan design, benefits coverage, and claims procedures for major medical, disability, and self-insured plans. We are knowledgeable about local, regional and national healthcare support services, including private and public organizations, and specialized critical care facilities. You can expect:
- Personal attention from a medically-trained benefits expert
- Improved patient outcomes and maximum use of existing health benefits dollars
- Narrative patient status reports
- Cost-benefit analyses that document case-by-case savings
- Comprehensive services at competitive fees
Case Management Services
Expertise and Reliability. Our experience enables us to provide reliable and comprehensive Case Management services. These services include:
- Group health: case management for insured or self-funded groups
- Disabilities: short- and long-term disability management
- Elder care: case management program for the elderly
- At-home care
- Health data analysis
- Benefits consulting
- Health plan communication materials
- Education and training
- Patient advocacy
Targeted Care. Case Management targets members who are most in need of guidance. A few examples of conditions covered by Case Management are:
- Cancer
- Neurological conditions
- Cardiovascular diseases
- Diabetes
- Respiratory disorders
- Premature birth
- High-risk pregnancies
- Organ transplants
- Traumatic head injuries
- HIV/AIDS
