Patient-Centered Healthcare
We understand the challenges when navigating the healthcare system.
That’s why we’ve developed a complete circle of care that puts your members first, streamlining the entire healthcare process from start to finish.
Programs
Offering a complete circle of care
Care Management
- Management of complex cases
- Coordination with care team to develop a comprehensive plan of care
- Personalized and individualized support to the member
- Use of clinical strategies and linkage to resources to improve patient outcomes
- Comprehensive summaries with cost projection resulting in competitive reinsurance carrier rates
Care Navigation
- Identification of high-risk members using data analytics
- High engagement rates based on collaborative communication strategy with client group
- Clinical support and guidance to assist members to better manage their conditions
- Focus on steerage to quality, cost-effective providers and facilities
- Improve patient outcomes by providing actionable data
Precertification
- Review for medical necessity using clinical criteria guidelines
- Focus on “review to approve” vs. “review to deny”
- Quick turn-around times to prevent delay in care
- Coordination with internal programs for clinical management
- Steer toward quality, cost-effective alternatives