Hospital hallwayHealth insurance is an effective way to ensure that you get the necessary medical help when needed. Everyone in the United States has medical coverage through Medicare or Medicaid and other commercially available insurance.

These insurance companies need a medical case management service. Medical case managers play an important role in not only the individual getting medical services but also the company or agency that provides the health insurance.

Below are the benefits that medical case management services provide.

They help reduce health care costs

Case managers assess, plan, monitors and evaluate the health services needed by the individual. For instance, you had had a vehicular accident and complained of neck and low back pain. The expected flow of health care provided to you would be ER treatments, and services then referred to your primary care physician for follow up.

After a vehicular accident, depending on the severity of your complaints and objective findings, the ER doctor will order diagnostic tests and imaging.

Case managers will ensure that if your doctor already ordered x-rays and laboratory tests, this will no longer be repeated with your primary physician, unless necessary to do so.

Coordinated care in between different providers

Suppose your primary care physician recommended physical therapy or chiropractic treatment for you. Though you have an option to choose your chiropractic doctor or physiotherapist, you can also get a referral. You would probably undergo a series of chiropractic treatment or physical therapy sessions.

After a specific period, you will get a reevaluation for progress by your medical doctor and will get a recommendation to continue or transition to a more effective treatment. Access to daily progress notes of your treatment will help your doctor evaluate your condition.

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The case manager helps in the coordination of these services by facilitating the exchange of information.

A medical case manager plays an important role in helping you access the right medical care for your condition. They also play a vital part in helping you to ensure that you collect payments for the treatment and services provided to clients.