Care Management means the overall method of providing ongoing health care in which the MCO manages the provision of primary health care services with additional appropriate services provided to an Enrollee. See section 6.1.5.
Care Management means a set of services, delivered by Care Coordinators, designed to improve the health of enrollees. Care management includes a health assessment, development of a care plan and monitoring of enrollee status, care coordination, ongoing reassessment and consultation and crisis intervention and case conferencing as needed to facilitate improved outcomes and appropriate use of health services, including moving the enrollee to a less intensive level of care management as warranted by enrollee improvement and stabilization. Effective care management includes the following:
Care Management means services that assist Enrollees in gaining access to needed services, including medical, social, educational and other services, regardless of the funding source for the services.
Examples of Care Management in a sentence
Involvement in Care Management does not guarantee payment by The Plan.
A regular employee who has successfully completed the CHA/CAN course Nursing Unit Administration and/or CHA Hospital Department Management Course and/or BCIT certificate program in Health Care Management, and is employed in a capacity utilizing the course(s) shall be paid an additional twenty-five dollars ($25.00) per month.
Care Management The goal of Care Management is to help the Member receive the most appropriate care that is also cost effective.
CMS will calculate the Practice’s Care Management Fees (“CMF”) according to the CTO Participation Agreement, the Practice Participation Agreement, and the methodologies described therein.
Care Management Costs 6 Administrative Expense Cost Allowance 6 State Taxes and Fees 6 Health Insurer Provider Fee (HIPF) 7 V.
More Definitions of Care Management
Care Management means services that assist Enrollees in gaining access to needed services, including medical, social, educational, and other services, regardless of the funding source for the services.
Care Management means observation, assessment, care planning and documentation of the resident's physical, cognitive and psycho- social needs and the supervision and coordination of the services provided to meet those needs by a licensed professional nurse.
Care Management means activities performed on behalf of members that include services described in rule 5160-26-03.1 of the Administrative Code.
Care Management means arranging for continuity of care and coordinating the array of service necessary for treating the child; communicating with responsible individuals, and providers at least every thirty (30) calendar days to assure services are being delivered as planned and adequate progress is being made; and the authority to rescind authorization for any treatment services with proper notice.
Care Management means a type of case management in residential substance use disorder (ASAM Level 3) treatment settings that includes assessment, development of a care plan, and referral and linkage to community supports and community-based or
Care Management means the application of systems, science, incentives, and information to improve practice and assist consumers and their support system to become engaged in a collaborative process designed to manage medical/social/mental health conditions more effectively. The goal of care management is to achieve an optimal level of wellness and improve coordination of care while providing cost effective, non-duplicative services. Clean Claim means a claim that can be processed without obtaining additional information from the PROVIDER, which is properly completed and contains all data elements necessary for processing in accordance with MSHN policies with all required data fields completed. It does not include a claim from a PROVIDER who is under investigation for fraud or abuse, or a claim under review for medical necessity. CMHSP stands for Community Mental Health Service Program. MSHN has 12 CMHSP partners each of which has a role in being a potential door for clients to access SUD services. Continued Service Criteria is when, in the process of client assessment, certain problems and priorities are identified as justifying admission to a particular level of care. Continued Service Criteria describe the degree of resolution of those problems and priorities and indicate the intensity of services needed. The level of function and clinical severity of a client’s status in each of the six assessment dimensions of ASAM is considered in determining the need for continued service. Continuity of Care – “means the quality of care over time, including both the patient's experience of a 'continuous caring relationship' with an identified health care professional and the delivery of a 'seamless service' through integration, coordination and the sharing of information between different providers”. Continuum of Care refers to an integrated network of treatment services and modalities, designed so that an individual’s changing needs will be met as that individual moves through the treatment and recovery process. Co-Occurring Disorders are concurrent substance-related and mental health disorders. Use of the term carries no implication as to which disorder is primary and which secondary, which disorder occurred first, or whether one disorder caused the other. Consumer means any individual who is determined by MSHN to be eligible for publicly funded substance use disorder treatment benefits.
Care Management means a type of case management in residential substance use disorder (ASAM Level 3) treatment settings that includes assessment, development of a care plan, and referral and linkage to community supports and community-based or lower level of care services to promote continued recovery after the individual discharges from the treatment facility.