Transplant Case Management
Experienced nurse specialists managing the complexities of transplant services
In 2011, nearly 28,000 adults received lifesaving organ transplants, with first-year associated costs ranging from
$263,000 for a kidney transplant to more than $1.2 million for an intestinal transplant (Milliman, 2011). American
Health’s experienced transplant specialty team offers an expert approach to patient care, ongoing support and generates
cost savings to clients. With more than 10 years of experience on average, our transplant case managers work with the
member, the member’s family and support network to provide comprehensive assistance
in all areas related to ongoing education, medical history, medications, development of support systems, lifestyle
changes and behavior modifications, and financial options.
If a client or stop-loss contract requires a referral to a specific network, our transplant specialists will work with the member and recommend an in-network transplant facility with the best services and location. They can access all available networks on a case-by-case basis in order to achieve the best discounts for our clients without an access fee. In most situations, because contracts exist between the Centers of Excellence and claims payers, transplant specialists act as liaisons between the two parties. When contracts are unavailable, they have the ability to work with Transplant Centers of Excellence, financial coordinators, reinsurance carriers and claims offices to coordinate services and negotiate discounts.
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Product Highlights
- Dedicated transplant specialists interact with members and families, offering a complete support network
- Extensive patient education and support program helps members achieve and maintain a healthier lifestyle, thereby reducing future medical costs
- Our comprehensive approach helps members and families meet the challenges of each stage of the process (pre-transplant, transplant and post-transplant)
