Medical Management

Medical Management is defined as the timely coordination of medical care to meet an individual’s healthcare needs and maximize the use of benefit dollars while supporting a quality medical treatment plan. It involves review of the whole picture of the participant’s health and medical status, problems, treatment necessary, treatment being given, and alternatives to care. It also includes a review of the cost of services, drugs, equipment, supplies; price negotiation; and long-term cost estimates. 

Medical Rehabilitation Consultants provide management of medical treatment plans for individuals who require coordination of catastrophic illness or injury, and for those who need assistance with management of chronic illness or complicated diagnostic or treatment problems. Medical case management services are based on referrals from the benefit plan administrator and cases identified through utilization review and disease management programs.