Allegiance’s integrated Case/Utilization Management programs leverage early intervention and acute case management to effectively coordinate and manage your group’s most medically challenging cases. These interventions utilize unique resources for creative approaches to maximize appropriate, cost-effective care. Dedicated case managers interact with members and their families, maintaining an ongoing relationship with the patient. Case & Utilization Management
Medical Risk Management Team A Fully Integrated, Multidisciplinary Approach to Managing the Cost of Healthcare Risk
Predictive Modeling Uses patterns in data to estimate the probability of a future financial or health outcome
CLIENT CASE MANAGEMENT
Trigger Diagnosis A clinical diagnosis, event, or behavior that presents an opportunity for case management intervention.
Stop Loss Reporting Reveals trends in health claims that can be used to proactively manage costs.
CARE & CLAIMS MANAGEMENT
Customer Service One-on-one support allows team to screen for likelihood of high-risk advancement.
COST & CARE MANAGEMENT
Self Identification Member communicates a need for support with a self-identified medical issue or behavior.
Cases are continually monitored to ensure quality and appropriateness of care.
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