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Care Management

Dean Health Plan cares for your patients

If your patients have been diagnosed with a chronic health condition or have a complex health care need, the Dean Health Plan Care Management Team offers various services to ensure we meet patient needs and address all questions and concerns.

Disease Management

We offer Disease management programs designed to help members get answers to questions about their disease and offer support to help manage chronic health needs. The program supports patient self-management through:

  • telephonic counseling
  • care reminders
  • referrals
  • long-term patient advocacy and support.

Case Management

A member can be identified for Case Management based on:

  • diagnosis
  • acute injury
  • health care provider referral
  • member's own request 

Case Management is free of charge. It provides a registered nurse as a resource during a time where health care may be intense or confusing. Your patient's case manager works with Dean network providers to meet their needs using available resources to deliver quality cost-effective care.

Utilization Management

The Utilization Management (UM) team reviews the appropriateness of medical services that members (your patients) receive before and after services are rendered. As part of the review, the team uses:

  • pre-admission certification
  • prior authorization
  • concurrent reviews
  • discharge planning
  • inpatient hospital admissions
  • skilled nursing facility & rehabilitation care
  • home health care services
  • hospice care
  • behavioral health outpatient care

These tools allow Dean to ensure members receive services and supplies that are medically appropriate and necessary for their condition. 

UM also identifies and evaluates a patient's health care needs after hospital discharge and directs members to specific outpatient providers when needed.