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Care Management

Dean Health Plan Cares For Your Patients

Sometimes navigating your way through the health care system can be challenging. That's where the Dean Health Plan Care Management Team comes in.

If your patients have been diagnosed with a chronic health condition or have a complex health care need, various services are available to ensure their needs are met and all their questions and concerns are addressed.

For the Health of your Patients

We offer Disease Management programs designed to help members get answers to questions about their disease and offers support to help manage chronic health needs. The Disease Management program specializes in supporting patient self-management through telephonic counseling, care reminders, referrals and long-term patient advocacy and support.

Support When Your Patients Need it Most

A member may be identified for Case Management based upon a diagnosis, acute injury or from a referral by you, their health care provider. They also have the option to request Case Management services.

Case Management is free of charge and provides members with a registered nurse who serves as a resource during a time where health care may be intense or confusing. Your patient's case manager will work with Dean network providers to meet their needs using available resources with the goal of delivering quality cost-effective care.

Focusing on Quality Care

The Utilization Management (UM) team uses pre-admission certification, prior authorization, concurrent reviews and discharge planning to review the appropriateness of medical services that our members (your patients) receive before and after services are rendered.

These tools allow Dean to ensure members are receiving services and supplies that are medically appropriate for the member and necessary for the condition being treated. The service review includes inpatient hospital admissions, skilled nursing facility and rehabilitation care, home health care services, hospice care and behavioral health outpatient care.

In addition, UM identifies and evaluates a patient's health care needs following hospital discharge and directs members to specific outpatient providers when needed.