Case management means a care management plan developed for a Member whose diagnosis requires timely coordination. All benefits, including travel and lodging, are limited to Covered Services that are Medically Necessary and set forth in the EOC. KFHPWA may review a Member's medical records for the purpose of verifying delivery and coverage of services and items. Based on a prospective, concurrent or retrospective review, KFHPWA may deny coverage if, in its determination, such services are not Medically Necessary. Such determination shall be based on established clinical criteria and may require Preauthorization.
Case management means a coordinated set of activities conducted for individual patient management of serious, complicated, protracted or other health conditions.
Case management means case management services accredited under 441—Chapter 24 and provided according to 441—Chapter 90.
Examples of Case management in a sentence
Case management - the costs of assessing, arranging, coordinating, and monitoring the delivery of individualized services to meet the needs of the program participant(s).
More Definitions of Case management
Case management means an organized service to assist individuals to select, obtain, and utilize resources and services.
Case management means the functions performed by a services coordinator. Case management includes determining service eligibility, developing a plan of authorized services, and monitoring the effectiveness of services and supports.
Case management means the ongoing coordination, by a case
Case management means a collaborative process of assessment, planning, implementation, coordination, monitoring and evaluation of the options and services required to meet a client’s health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes.
Case management means the services provided to assist individuals who reside in a community setting or are transitioning to a community setting in gaining access to needed medical, social, educational, entitlement, and other applicable services.
Case management means those activities of local public health personnel
Case management means coordinating the assistance needed by