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Medical Management

August 16th, 2019

The Care Management department of Medial Network One works in conjunction with our primary care physicians and the insurance plans to process referrals and authorization requests.  Marsha (working remote) and Christina (in office) review the requests for appropriateness and accuracy.  We verify that all servicing providers and facilities are contracted and are available to assist with questions and or concerns.  Also, another important member of our Medical Management Team is Ilene.  Ilene prevents readmission to hospitals by notification of PCP that their patient was admitted, where, why and any other pertinent information.  They are notified by phone or fax, some offices/patients are covered by one of our Care Managers and they handle those notifications.  Then all this information is entered into WellCentive.  Also, Ilene does patient transfer by removing a patient from a PCP practice if it meets specific criteria.

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