Case Management

Ensures appropriate care while maximizing cost savings

American Health's URAC-accredited Case Management services are designed to improve the quality of patient care while maximizing cost savings. We provide individuals a better understanding of specialized care needs, access to centers of excellence and specialty care facilities, education on alternatives to costly inpatient care, and direction toward in-network discounts. We work with members to educate and help them make choices that contribute to a healthier lifestyle, thus reducing the incidence of complications and future medical costs.

Our integrated programs provide triggers that automatically refer cases that may benefit from Case Management intervention, helping to facilitate early identification, prevent rehospitalization, and significantly reduce costs.

Solutions and Support

Nurse Case Managers are licensed registered nurses who function as advocates, facilitators, and educators, assuring that members make smooth transitions from inpatient settings to alternate care and home care when appropriate. Other benefits and services include:

  • Preparation and planning through health management
  • Effective communication
  • Follow-up and reporting
  • Treatment and care facilitation
  • Identification of support groups and systems
  • Minimization of future complications through health management Specialty Case Management services for Neonates, Oncology, and Transplants

  • Comprehensive approach to patient-focused support and life management to improve the quality of patient care while maximizing cost savings
  • Access to a dedicated Nurse Case Manager who interacts with patients and family, offering a complete support network
  • Access to American Health's board certified Medical Director, and to a panel of board certified practicing physician specialists
  • Reporting capabilities including accurate projections on costs for future needs and statements of prognosis
  • We report all Never Events and Avoidable Hospital Conditions

To learn more about American Health's Case Management program, please call us at (866) 614-4244 or send an email to marketing@AHHinc.com.