Case Management Options

Below is a list of Case Management resources that physicians and other health care providers can refer to when working with patients. Resources range from the 24 Hour Medical Help Line to Comprehensive Case Management and hospital alternatives.

Resources

Independent Health 24-Hour Medical Help Line

We offer a 24-Hour Medical Help Line to our members, which allows them to speak with an experienced healthcare professional to get answers to their questions and find out what steps they may need to take in managing their healthcare conditions.

Independent Health Case Management

Independent Health offers a variety of Case Management programs that can assist providers to coordinate appropriate care for their patients. Programs are coordinated by professional case managers.

Independent Health Case Managers are licensed health professionals, Registered Nurses, Social Workers, and also include a Certified Diabetic Educator/Registered Dietitian, Exercise Physiologist, Behavioral Health Specialists, and a Physical Therapist.

Below is a list of programs available:

Case Management

Independent Health provides a full spectrum of Case Management services, including short-term and complex case management. Our case management specialty areas include:

  • Asthma
  • Behavioral Health
  • Cancer
  • Cardiovascular Disease
  • CHF
  • CKD
  • COPD
  • Diabetes
  • HIV/AIDS
  • Medicaid Long-Term Support Services (PCA, CDPAS, etc.)
  • Multiple comorbid conditions
  • Pediatric – Including high risk populations such as foster care and medically fragile children.
  • First Step Maternal Child Program

Distinguishing Features of Case Management:

  • Interventions are typically most likely to be successful for members with several chronic comorbid conditions, often complicated by psychosocial issues, who are at substantial risk of hospitalization in the coming year.
  • Contact with members is by telephone.
  • Access to timely information on hospital admissions and ER visits.
  • Focus is on helping members and/or caregivers manage their own health care and assist in arranging for social supports, as needed.

Social Determinants of Health

Independent Health Case Managers utilize a medical-social model of Case Management to assist in addressing barriers to care.

  • Life Enrichment Specialist – Medicare line of business
  • Community Resource Facilitator – Commercial and MediSource lines of business
  • Social workers skilled in working with high-risk/economically disadvantaged populations

Utilization Management - Hospital Alternatives

Utilization management staff are available to assist you in coordinating expedited care for your patients experiencing a non-emergent medical event to the most appropriate level care (sub-acute nursing facility or home care) as an alternative to a lengthy and possibly unnecessary ER visit and/or hospital stay.

Utilization Management can be reached at 716-635-3523.

and services are coordinated when a patient is presented to you with specific conditions such as:

  • Wound care and/or infection requiring infusion therapy.
  • Placement in a subacute facility for rehabilitation and/or condition stabilization.
  • Exacerbation of chronic conditions such as CHF, COPD and pneumonia.

Behavioral Health CM – 716-529-3945
Medical Case Management – 716-635-7822
Utilization Management – 716-635- 3523