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Comprehensive HMO Case Management Includes:
Maximizing Reimbursement for High-Cost Care
For patients receiving IV antibiotics, wound care, extensive therapy or expensive medication, we obtain the highest eligible rate of reimbursement—either for the entire stay or specific dates of service.
Medication Carve-Out Review
Expensive medication alerts are analyzed to identify potential carve-outs, ensuring accurate billing and minimizing financial loss.
Continuous Monitoring Through Discharge
Our case managers closely monitor each stay, maintain communication with facility teams, and advocate for authorizations that cover the full clinical need through discharge.
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