Medical Management
Distinguishable Approach
The Administrative Services Plan offers distinguishable medical leadership that includes collaboration among Dean Health Plan Medical Directors and the Chief Medical Officer. This partnership provides each client with staff that boasts strong clinical experience throughout many markets. We have a 27+ year track record of success and our dedication to quality has been recognized by NCQA with Excellent Accreditation since 2001.
On-Site Medical Leadership
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Provider Collaboration
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- Chief Medical Officer & Medical Directors
- Strong clinical experience in many markets
- Significant interaction with provider community
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- Physicians, nurses, pharmacists
- Clinics, hospitals, pharmacy
- Opportunity to increase quality and decrease cost in care delivery
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Prevention Services
Goal
Dean Health Plan's goal is to remind members, via message-specific mailings, of needed preventive care based on age, risk factor and/or clinical appropriateness. We encourage preventative screenings, tests and care that will improve members’ health.
Programs
Currently DHP has preventive health programs that focus on:
• Diabetes
• Childhood Immunizations
• Adult Screenings
• Appropriate Antibiotic Use
• Women’s Health
Utilization Management
Goal Our goal is to ensure the utilization of medical services are medically necessary, at the correct level of care and coordinate out-of-network care within the terms of the health plan.
Programs
The review of services includes:
• Pre-certification/Pre-Authorization of selected
inpatient and outpatient services
• Care Coordination also called "Inpatient Case
Management Review"
• Recommended Prior Authorization List
• ER Frequent Flyer Program
Case Management
Goal 
Dean Health Plan's goal is to enhance the quality of health care outcomes for a member diagnosed with a high dollar diagnosis, which may include a catastrophic illness or trauma-related event.
Programs
• Complex Case Management
• Transplant Case Management
• High Risk OB Case Management
Case Management programs are voluntary.
Disease Management
Goal
Dean Health Plan's goal is to work with members to develop and implement a self-care regimen for managing their chronic condition for best possible health outcomes.
Programs
• Heart Failure
• Diabetes
• Other high level chronic conditions such as COPD
Disease Management programs are voluntary.
