Woman & Doctor

Obtaining, Managing & Tracking Authorizations.

Working directly with the Admissions department, our case managers “take over” the authorization management once a managed care patient admits. This includes authorizations for Commercial, Medicare Advantage, Workers Comp, No Fault, Medicaid Managed Care (skilled), Secondary/ Copayment, & MLTC/MLTSS/Long-Term Custodial payers. 

 

Comprehensive HMO Case Management Includes:

  • Reviewing each HMO patients’ medical records, diagnoses, care plan, and streamlining all communication to one point of contact.

  • Independently reviewing each patient’s authorization and cross referencing it to the care provided to ensure the appropriate level and highest rate of reimbursement is approved as per the HMO contract.

  • Being proactive with denial management and using our experience in HMO case management to communicate with Insurance case managers.

  • Tracking all authorizations and ensuring that auth details are properly conveyed to billing department – in a timely manner.

We'd love to see how we can help. Contact Us Today! 

2376 60th Street  Suite 201, Brooklyn, NY 11204

Tel: 855-605-5800

HMO Case Management