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Complex and Catastrophic Case Management
Do you have patients with serious conditions who need a variety of health care professionals and treatment plans? These kinds of patients may sometimes benefit from intensive care coordination. Examples include terminal cancer, head injuries or spinal cord injuries. We have a special program for these patients who suffer a catastrophic event or chronic condition. The program coordinates health care resources, alternative treatment plans and benefits to help members get through this difficult time.
We work together as a team. We involve the member, health care professionals and the member's family. Our Registered Nurse case managers will also draw on our excellent menu of health and disease management programs. This helps our members get the educational materials and clinical support they need.
Do you think this program would help any of your patients? A doctor may contact Health Care Services to request evaluation for our case management services. You can also call to discuss a member's treatment. A case manager will review information from the doctor, member and other sources to see if the member qualifies for our program.
Once we have reviewed a referral, we either accept or decline the case. If we accept the case, the case manager will coordinate a care plan. This includes identifying the problems, goals and interventions.
If you have questions or if you'd like to refer a patient, please call (800) 327-3183, extension 25588.