Whether members are experiencing a medical crisis, living with multiple chronic conditions, facing a serious mental illness, or a combination of these, our URAC and NCQA accredited medical and behavioral health case management services will help your members attain healthier lives while your plan controls costs.
Our integrated approach takes into account the physical, behavioral and social issues that may be complicating an individual’s health. With our Dynamic Somato-Social Theory, we address and manage not only the present diagnoses, but also the overall well-being of the member. In doing so, potential barriers to care are avoided, helping to control utilization and compliance.
Our licensed and highly skilled nurses and behavioral health clinicians are committed to assisting members facing or risking a health crisis. They work closely with providers to assure quality care and appropriate services are delivered while cost-effectiveness is maintained. Additionally, they coordinate with caregivers, community resources and services so all parties are working toward a common goal – the best interests of members.
A health crisis or behavioral health condition can lead to frequent emergency room visits, lengthy inpatient stays and redundant services, all of which lead to higher costs. Our integrated and well-coordinated solution avoids this by managing utilization while supporting excellent care. This increases your members’ quality of life and reduces the demand on your resources – both of which drive savings.
Contact us today to learn more about how our medical and behavioral case management solution can benefit your health plan and its members.