What is CARE ADVISER?
Using a full-spectrum approach, our Care Management team is committed to improving the quality of care and achieving the best outcomes for plan members and your bottom line.
TPAs, Brokers, Fully-Insured and Self-Funded Plans
Reduce costs and gain your advantage in the marketplace. RN Case Managers educate and work on behalf of groups and members to navigate through high-cost care and hospitalizations, avoiding costly care ⎯⎯ hospital
re-admits, wasteful practices, etc.
MGUs and Stop-Loss Carriers
Set reserves and be more strategic with your renewals using robust Care Management summary reporting. Enjoy lower costs with Automated Trigger Discounts, automating CM referrals generated at Pre-Cert.
Physician reviews from experts across multiple specialties are facilitated and delivered to you for optimal decision-making capabilities.
Transplant Carve-Out Programs
Take advantage of exclusive access to multiple transplant networks and enjoy the freedom of choice. Our specially-trained nurses can guide you along
Plan Members, Family and Caregivers
Patient empowerment delivered! Through tailored education and interventions, we can address patients with complex / chronic conditions and comorbidities, giving them the tools to steer their treatment in the
Compassionate Care Meets Innovation
Comprehensive State Licensure
Diligent monitoring and careful evaluation of the appropriateness of care at every level ensures patient satisfaction and improved health
Full customization to meet the needs of any plan
Record UM response times significantly lower than URAC standards
URAC Accredited Case Management
Registered Nurse Certified Case Managers provide coordination of care across the continuum, maintaining a close connection with the member / family / caregiver(s) along their treatment journey
We specialize in Evidence-Based Guidelines for Diabetes, Asthma, Congestive Heart Failure, Coronary Artery Disease, COPD and Hypertension
Accessible reporting and secure data portals are available for Stop-Loss Carriers, Plan Administrators
Automated Trigger Diagnosis
Advanced notice of chronic conditions and catastrophic diseases plus referral to CM / DM programs for closer monitoring and care involvement