Case Management:
Effective Oversight for the Most Complex Cases
MedWatch’s certified nurse Case Managers review, monitor, and advise on the most acute and complex cases to improve quality of patient care and minimize treatment costs.
Case Management You Can Trust
MedWatch’s URAC Accredited CM Program supports patients by collaborating with their providers, proactively addressing needs, reviewing treatment plans, and providing options that enhance patient care while reducing costs. MedWatch’s accreditation in Case Management demonstrates our ongoing commitment to delivering quality services by providing the highest standards of care.
Our Program Is Designed to Produce Better Outcomes
MedWatch’s skilled Registered Nurse Certified Case Managers proactively engage and educate patients, family members, and providers with the goal to provide specialized oversight to improve the care pathway from admission through discharge. No matter how acute or complex the need may be, MedWatch has specialized Case Managers that work together with the patient and their team to review treatment plans and provide options to improve outcomes.
MedWatch Case Management identifies possible candidates through:
- Precertification Activity
- Multiple Admissions
- Clinician Assessments through Utilization Review Activity
- Trigger Diagnoses
- Pathology, Radiology, and Other Diagnostic Outcomes
- Referrals from the Plan, Administrator, or Patient
Average Payer Savings Ratio
Specialty Case Management
Cost-Saving Components for Every Case
MedWatch Case Management helps control the high costs of acute and complex cases which includes medical necessity reviews, looking at options for surgical bundles, pharmaceutical bundles, and Centers of Excellence.
Centers of Excellence & Specialty Networks
Highly personalized, comprehensive, expert care provided through secured network, hospital and outpatient care centers for transplants, oncology, orthopedics, and more.
Pharmaceutical Solutions
Focuses on high-cost, specialty, and maintenance medications with our programs dedicated to providing significant savings
Surgical Bundles
All-inclusive packages that cover the most commonly performed surgical procedures at a cost well below traditional PPO rates
Medical Necessity Reviews
Nurse Case Managers review targeted treatment plans relative to approved clinical standards and benefit plan design
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