Field Case Management services are utilized
for more complicated and/or catastrophic cases. A network
of RN’s with national certifications (CCM and/or
CRRN) and at least 3-5 years experience in catastrophic
case management are assigned to the files which are in
Field. Cases can be identified from onset as catastrophic
or directed to on-site if treatment direction goes off
track.
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Initial contact takes
place within 24-hrs of referral receipt for CAT cases;
48-hrs for all others. Lifetime Cost Projections are completed
at the time of initial evaluation. Treatment is steered to
in-network providers whenever possible; rate negotiations
will take place for out-of-network treatment. The Nurse
attendance at appointments facilitates the ability to decrease
lost time days.
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