We’ve designed our complex care management services for your Network Health patients who have the most complex health needs.

To help your Network Health patients attain optimal, functional well-being, initiate early interventions to avoid complications, and minimize the onset of secondary disabling conditions, our complex care medical management objectives include:

• Performing risk assessments and evaluations
• Providing a coordinated care planning approach
• Using health care resources appropriately and in line with clinical guidelines
• Providing targeted health education to you, your Network Health patients, and their families
• Providing a link between a patient’s health services and available community resources
• Facilitating communication between you and your Network Health patients
• Educating and empowering your Network Health patients to take an active role in managing their health
• Decreasing emergency room visits
• Decreasing acute inpatient legnth of stay

You can refer one of your Network Health patients for complex care management without getting prior authorization if they have:

• An identified complex medical condition and chronic disease(s)
• A complex medical condition or catastrophic episode-related acute inpatient admission
• More than one complex disease/condition

For more information about our complex care medical management program, call us at 888-257-1985.