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.

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.

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.

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 may also include 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.

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

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

• If you have questions or a special situation please feel free to contact the diocese.

More Definitions of Medical case management

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.