Case Management

HSAG provides case management/disease management services for individuals with complex medical needs. Our staff includes board-certified physicians, registered nurses, certified case managers, and nationally recognized experts in health care management. HSAG also contracts with more than 150 multi-specialty, board-certified physician advisers who assess patients’ medical conditions to determine medical necessity, appropriateness of treatment plans, and whether the quality of delivered care meets evidence-based community standards.

By adhering to strict confidentiality requirements while striving to obtain a positive outcome for the patient in the most cost-efficient manner, HSAG case managers can:

• Coordinate medical services such as home health care, durable medical equipment needs, and hospital discharges or transfers to post-acute levels of care.
• Coordinate services and promote communication between physicians, health care facilities, and providers.
• Evaluate/track insurance benefits for medical necessity and eligibility of treatments, services, and medical equipment needs.
• Seek alternatives for the patient if insurance coverage does not meet medical or psychosocial needs.
• Provide information about disease processes to minimize complications and, where possible, reduce acute illness and hospitalizations.