Transplant Case Management

Experienced nurse specialists managing the complexities of transplant services

Transplant Case Management 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.

Click here to see our Transplant Case Management key statistics

 

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)


Testimonials

  • Flexibility has always been at the top. American Health goes out of its way to be in the forefront of new services and new products. They have a broad scope of case managers with a variety of specialties. They're cutting edge and a leader in the medical management industry.
    Kerry Kovaleski
    Director of Medical Management & Provider Relations
    Arizona Foundation for Medical Care Phoenix, AZ
  • American Health has provided Case Management and Utilization Review for Cerner HealthPlan Services since 2007. Case Management helps improve our members' experience through education, case oversight and identifying alternative care options when appropriate to maximize their health benefits. Utilization Review ensures oversight of inpatient and outpatient procedures for the most cost-effective, quality treatments to help realize health plan savings and appropriate health care services for our members. American Health plays a role in our ability to exceed our clients' expectation for benefits administration.
    Betty Safford
    Director, Client and Quality Operations
    Cerner HealthPlan Services, Cerner Corporation Kansas City, MO
  • I am very pleased with all the timely efforts of American Health with our implementation and once we went live. My relationship with American Health is great, and I want to thank them for all their efforts in making this relationship a success.
    Erica Smith
    Claims Supervisor
    Lockard and Williams Insurance Pascagoula, MS
  • The case managers that I have a relationship with are extremely pleasant, knowledgeable, thorough and receptive - every word you could possibly think of. They're awesome. Our case management supervisor is an incredible go-to person for me.
    Joni Clover
    Claims Department Manager
    Employee Benefit Systems Burlington, IA
  • We have used American Health Holding for over five years. I have always found their staff friendly and knowledgeable. There have been a few instances where we have looked for a unique service or had a specific request. American Health Holding has always been quick to respond to our requests and has gone above and beyond to fulfill them. We have had measurable cost savings to our Plan by using the diverse suite of resources available to us by American Health Holding. They are truly a pleasure to work with.
    Melissa Crawford
    Claims Supervisor
    Iron Workers District Council Rochester, NY