Medical Case Management

The MedWatch RN Case Managers serve to liaison activities between medical providers, patients/families, and payers. They proactively investigate and arrange any avenue for cost containment. These activities include, but are not limited to: facilitating discharge to a lower level of care, negotiating discounts, medical necessity reviews for home care, SNF and acute rehabilitation, network steerage, and repricing referrals.

The case managers provide well documented, research based reports that include cost projections and professional assessments. The case manager researches the treatment plan for appropriateness and notifies the claims office of any off-label or experimental treatment. She provides support and education to the patient and facilitates communication between all members of the health care team. In addition, she ensures that the patient receives the highest quality, most cost-effective care within the guidelines of the plan. Three levels of case management are available to meet the needs of the patient while conserving the group’s assets.

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