About Case Management

Case management services are provided when a covered person has a medical condition that requires intensive or complicated medical treatment, or long or multiple inpatient stays. Examples of acute injury or illness include head trauma, spinal cord injuries or individuals diagnosed with mental health, chemical dependency or HIV.

Case managers—usually registered nurses—work with the patient, family, attending physician and other involved parties, such as home health care providers, to make sure the patient is receiving care that's medically necessary and appropriate throughout the course of treatment. Participation in a case management program is completely voluntary and confidential.

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