Care Line (Demand Management)

 

Medical costs are reduced through the education of members on treatment alternatives and care settings.

American Health’s Care Line is a Demand Management service that provides callers with toll-free, confidential health care advice and information, 24 hours a day, 365 days a year.  Callers have the options of accessing an extensive Health Information Library, speaking directly to a Registered Nurse for counseling or advice, or get information on national health care resources.  The program is based on the premise that informed patients make better and more cost-effective health care decisions.

 

Fast Facts

• The program is staffed by a team of specialty-trained nurses who are supported by a flexible software system.  The protocols are established by Micromedex for adults and Barton D. Schmitt for children, the standards for computerized clinical information systems.  These guidelines provide consistent, accurate triage information, as well as home treatment options and health education.
• There is an extensive Health Information Library covering issues from women’s health to pediatrics and issues with senior adults.  Detailed directories provide members with topic codes and instructions for access to health-related topics.
  When members choose to talk directly with a nurse, they can discuss a current illness or health issue, or receive counseling on chronic conditions.  Nurses can also educate callers about treatments, lifestyle choices and self-care strategies.
• Around the clock integration with our Utilization Management services allows members and providers to call to initiate precertification anytime, 24 hours a day.