Complex Case Management (CCM) definition
Complex Case Management (CCM) means care coordination services delivered to enrollees with multiple or complex conditions to obtain access to care and services and coordination of their care. Enrollees receiving CCM services shall receive services according to standards defined by the National Committee for Quality Assurance (NCQA).
Examples of Complex Case Management (CCM) in a sentence
A team of professionals serving Members identified as requiring Conflict Free Case Management (CFCM), Care Management (CM), or Complex Case Management (CCM) that collaborate, in person and/or through other means, with Members to develop and implement an Individualized Care Plan (ICP) that meets Members’ medical, behavioral, Long-Term Services and Supports (LTSS), and social needs.
An appropriately qualified professional who is the Contractor’s designated accountable point of contact for each Member receiving Case Management (CM) or Complex Case Management (CCM).