Medical case management definition

Medical case management means the planning and coordination of health care services appropriate to achieve the goal of medical rehabilitation. Medical case management may include medical case assessment, including personal interview with the injured worker, assistance in developing, implementing and coordinating a medical care plan with health care providers in consultation with the injured worker and his or her family, and evaluation of treatment results. The goal of medical case management should be to avail the injured worker of reasonable treatment options to ensure that he or she can make an informed choice. Medical Case Managers shall not provide medical care or adjust claims.
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Medical case management means services provided by a Primary Care provider to ensure the coordination of Medically Necessary health care services, assuring the provision of preventive services in accordance with established standards and periodicity schedules and ensuring continuity of care for Medi-Cal enrollees. It includes health risk assessment, treatment planning, coordination, referral, follow-up, and monitoring of appropriate services and resources required to meet an individual’s health care needs.
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Medical case management means Medical Disability Management and Utilization Management. "Medical Disability Management" means the determination of medical necessity, appropriateness of care, length of stay, intensity of service related to treatment of HCO Enrollees by Network Providers. "Utilization Management" means the management, assessment, improvement or review of patient care and decision making through case by case assessment of the medical reasonableness or medical necessity of the frequency, duration, level and appropriateness of medical care and services, based upon professionally recognized standards of care, which may include prospective, concurrent or retrospective review of a request for authorization of medical treatment.
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Examples of Medical case management in a sentence

  • Medical case management includes the provision of treatment adherence counseling to ensure readiness for, and adherence to, complex HIV/AIDS treatments.

  • Medical case management shall be provided by COUNTY public health services.

  • Medical case management may also include the provision of treatment adherence counseling to ensure readiness for, and adherence to, complex HIV/AIDS treatments.

  • Conducting Medical Case Management Medical case management for children with EBLLs is largely predicated on a secondary prevention model (i.e., intervention after an EBLL has been detected, usually prior to the onset of symptoms).

  • Medical case management provided by the third-party administrator.

  • Medical case management includes the provision of treatment adherence counseling to Ryan WhiteHIV/AIDSProgramensure readiness for, and adherence to, complex HIV/AIDS treatments.

  • Medical case management includes the provision of treatment adherence counseling to ensure readiness for, and adherence to, complex HIV/AIDS treatments.Key activities include (1) initial assessment of service needs; (2) development of a comprehensive, individualized service plan; (3) coordination of services required to implement the plan; (4) client monitoring to assess the efficacy of the plan; and (5) periodic re-evaluation and adaptation of the plan as necessary over the life of the client.

  • Medical case management includes the provision of treatmentadherence counseling to ensure readiness for, and adherence to, HIV/AIDS treatments.

  • Medical case management services seek alternative settings and providers, coordinate the sequence of care by facilitating communications among providers and patient, and perform continuous monitoring of care.

  • Medical case management is a clinical goal-directed process requiring communication and coordination of all available resources to promote both quality and cost-effective outcomes.


More Definitions of Medical case management

Medical case management means a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill, or injured individuals.
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Related to Medical case management

  • 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.

  • 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;

  • Medical care means amounts paid for:

  • Drug therapy management means the review of a drug therapy regimen of a patient by one or more pharmacists for the purpose of evaluating and rendering advice to one or more practitioners regarding adjustment of the regimen.

  • 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.

  • 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).

  • 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.

  • Executive Management means the CEO and the CFO for purposes of administering this Plan.

  • 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.

  • Emergency medical care means such medical procedures as:

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

  • Medical cannabis means the same as that term is defined in Section 26-61a-102.

  • 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.

  • Medical cannabis pharmacy means the same as that term is defined in Section 26-61a-102.

  • Emergency management means lessening the effects of, preparations for, operations during, and recovery from natural, technological or human-caused disasters. These actions are broad in scope and include, but are not limited to: disaster plans, mitigation, preparedness, response, warning, emergency operations, training, exercising, research, rehabilitation, and recovery activities.

  • 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.

  • MEDICAL STAFF LEADER means any Medical Staff Officer, department chair, section chief, and committee chair.

  • Medical cannabis card means the same as that term is defined in Section 26-61a-102.

  • State Management Committee means a Committee comprising representatives from the Confederation of Western Australian Industry, the Trades and Labor Council of Western Australia, Technical and Further Education (TAFE) and the relevant Federal and State Government Departments which approve traineeship arrangements by agreement of each of the parties. The State Management Committee may be established pursuant to the provisions of the Industrial and Commercial Training Act, 1975 or any amendment to or substitution of that Act, provided that any Committee or body established in lieu of the State Management Committee has the same representatives structure and decision making processes as that Committee.

  • Medical physicist means a person trained in evaluating the performance of mammography equipment and facility quality assurance programs and who meets the qualifications for a medical physicist set forth in 41.6(3)“c.”

  • 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.

  • 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.

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

  • Medical examiner means a physician with training in aviation medicine and practical knowledge and experience of the aviation environment, who is designated by the Authority to conduct medical examinations of fitness of applicants for licences or ratings for which medical requirements are prescribed;

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

  • Project Management The individuals appointed by each Party cf. clause 4.1 in the Agreement.

Most Referenced Clauses

Most Referenced Definitions