Services Offered

Clinical Resource Partners

• Dialysis Networks and Negotiations
• Oncology Specialists and Services
• Neonatal Clinical Management
• Congenital Heart Networks and Management
• Access to Multiple Transplant Networks - Centers of Excellence/Medical Advisory
• Specialty Pharmacy Services/Medical Necessity Reviews/Treatment Protocol
• Experimental and Investigational Plan Language Wording Assistance

Physician Advisory

• Medical Necessity Reviews for Pharmacy
• Medical Necessity Reviews for Treatment Protocols
• Level of Care Review
• Experimental and Investigational Medical Advisory Reviews

Financial Review

• Independent Negotiation Services
• Hospital Bill Reviews for Costs/Appropriateness/Level of Care
• Forensic Hospital Claims Review
• Dialysis Networks and Discounting

Educational Offerings

• Quarterly web-based seminars
• Continuing Education Units
• On-site Programs

Sample Topics include:

• Anomalies and cardiac disease of newborns
• Pharmacy Management/Service Delivery Options
• Oncology Treatment
• CHF management
• Dialysis overview: Coverage and maximizing cost efficiencies
• Documenting Case Management Success: Cost Benefit Analysis Reports
• Home Dialysis
• Reinsurance: The Case Manager's next layer of support
• Sub-acute care and current trends in managed care
• Training claims personnel to identify claimants in need of special care
• Transplant management for case management and claims personnel