Case Management Program definition

Case Management Program means a program that assesses the Member’s medical needs and includes working with PARTICIPATING MEDICAL GROUP and other Participating Providers to explore and coordinate treatment alternatives that may (1) be more cost effective; (2) result in better medical outcomes; (3) achieve benefit savings; and (4) increase Member satisfaction.
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Case Management Program means a collaborative process
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Case Management Program means a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes. Case management programs include care management or disease management programs.
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Examples of Case Management Program in a sentence

  • Perez and Gonz ´ alez ´ (2008) presents evidence that investors’ tax status affects firm dividend policy.

  • Anthem’s Case management program is a collaborative effort aiding both providers and members ranging from short-term assistance to meet care gaps to longer term, intensive, and holistic case management for our members with the most intense needs.

  • The Plan Administrator reserves the right to reconsider if the Covered Person becomes compliant with the requirements of the Case management program.

  • Our Case management program began w ith staff providing outreach services (staff provided basic inf ormation about nutrition sites, senior activities, educational programs, transportation, etc.) but quickly advanced to case management services as the staff saw an increasing number of senior adults w ith larger issues.

  • Case management program models have proven effective at reuniting homeless youth—even those with troubled histories—with their families.

  • Case management program for people who need housing, but might not need the long-term level assistance.

  • FCM and Healthy Start programs will continue to provide information, referral, and linkage to primary care to non-pregnant women ages 18-44 years of age, and to assist them in enrolling in the state Medicaid family health insurance program when eligible.IDHS and IHFS will implement the High-risk Interconceptional Care Case management program.

  • If it is thought that the only possible meaning there may be would be subjective, we may have to accept that nothing really matters.The key question I am interested in throughout this thesis is whether we are making some kind of mistake in thinking that things genuinely matter.

  • At its sole discretion, in the context of an Individual Case management program, BCBSHP may also provide or arrange for alternative services or extra-contractual benefits which are either (i) excluded by this Contract; (ii) neither excluded nor defined as Covered Services under this Contract; or (iii) exceeding the maximum for any Covered Service under this Contract.


More Definitions of Case Management Program

Case Management Program means the specific supervision and management of the medical care provided or prescribed for a specific individual, which may include the use of health care providers designated by the carrier.
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Related to Case Management Program

  • 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 services means planned referral, linkage, monitoring and support, and advocacy provided in partnership with a consumer to assist that consumer with self sufficiency and community tenure and take place in the individual’s home, in the community, or in the facility, in accordance with a service plan developed with and approved by the consumer and qualified staff.

  • Database Management System (“DBMS”) is a computer process used to store, sort, manipulate and update the data required to provide Selective Routing and ALI.

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • Project Management Plan means the portion of the Project Development Plan providing the information requested in Section 4.2 of Exhibit B to the ITP.

  • Targeted case management means services that assist a beneficiary to access needed 2 medical, educational, social, prevocational, vocational, rehabilitative, or other community services. The 3 service activities may include, but are not limited to, communication, coordination and referral;

  • Case manager means a Department of Human Services or Area Agency on Aging employee who assesses the service needs of an applicant, determines eligibility, and offers service choices to the eligible individual. The case manager authorizes and implements the service plan and monitors the services delivered.

  • Virginia Stormwater Management Program or “VSMP” means a program approved by the State Board after September 13, 2011, that has been established by a locality to manage the quality and quantity of runoff resulting from land-disturbing activities and shall include such items as local ordinances, rules, permit requirements, annual standards and specifications, policies and guidelines, technical materials, and requirements for plan review, inspection, enforcement, where authorized in this article, and evaluation consistent with the requirements of this article and associated regulations.

  • Service Management System (SMS) means an off-line system used to access, create, modify, or update information in a Database.

  • Management Plan means a plan to manage the activities and protect the special value or values in an Antarctic Specially Protected Area or an Antarctic Specially Managed Area.

  • Prescription monitoring program “PMP,” or “program” means the program established pursuant to 657—Chapter 37 for the collection and maintenance of PMP information and for the provision of PMP information to authorized individuals.

  • Adaptive management means reliance on scientific methods to test the results of actions taken so that the management and related policy can be changed promptly and appropriately.

  • Security Management Plan means the Supplier's security management plan prepared pursuant to paragraph 3 of schedule 2 an outline of which is set out in paragraph 2.7 of the Order Form as updated from time to time;

  • Nutrient management plan means a plan developed or approved by the Department of Conservation and Recreation that requires proper storage, treatment and management of poultry waste, including dry litter, and limits accumulation of excess nutrients in soils and leaching or discharge of nutrients into state waters.

  • Asset Management Plan means a strategic document that states how a group of assets are to be managed over a period of time. The plan describes the characteristics and condition of infrastructure assets, the levels of service expected from them, planned actions to ensure the assets are providing the expected level of service, and financing strategies to implement the planned actions. The plan may use any appropriate format, as long as it includes the information and analysis required to be in a plan as described in Ontario’s Building Together: Guide for Asset Management Plans.

  • Change Management means the add-on module to the Programs that enables engineers to define network changes through one or more configuration templates. Those network changes can be applied to multiple devices and executed/rolled back automatically. The Change Management module enables engineers to verify the impact of the changes across the network to help ensure a safer change process.

  • Utilization management section means “you or your authorized representative.” Your representative will also receive all notices and benefit determinations.

  • Quality Management Plan means the portion of the Project Development Plan providing the information requested in Section 4.3 of Exhibit B to the ITP.

  • Virginia Stormwater Management Program authority or "VSMP authority" means an authority approved by the State Board after September 13, 2011, to operate a Virginia Stormwater Management Program.

  • Exit Management means the obligations and rights of the Parties to ensure a smooth transition of the Framework from the Contractor to the Authority or any Replacement Contractor as set out in Clause 44 (Exit Management) and Schedule 8 (Exit Management).

  • Forest management plan means a written plan prepared and signed by a qualified forester that prescribes measures to optimize production, utilization, regeneration, and harvest of timber. The forest management plan shall include a schedule and timetables for the various silvicultural practices used on forestlands, which shall be a maximum of 20 years in length. A forest management plan shall include all of the following:

  • Stormwater management plan means the set of drawings and other documents that comprise all the information and specifications for the programs, drainage systems, structures, BMPs, concepts and techniques intended to maintain or restore quality and quantity of stormwater runoff to pre-development levels.

  • Procurement Management means the Director of Lee County’s Procurement Management Department or designee.

  • Earned value management system means an earned value management system that complies with the earned value management system guidelines in the ANSI/EIA-748.

  • Safety Management System means a systematic approach to managing safety, including the necessary organisational structures, accountabilities, policies and procedures;

  • Public Finance Management Act ’ means the Public Finance Management Act, 1999 (Act No. 1 of 1999);