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Services

Care Management

The purpose of Care Coordination is to sync all the care delivered to you, the patient.

When care is coordinated, communication is stronger, and health can improve. Patients with coordinated care receive effective coordination of care across the medical neighborhood and between care team members.

Care Coordination means strong communication across all elements of the broader health care system, including specialty care, hospitals, home health care, community services and supports.

Poor coordination of care drive up cost and harm patient health, especially for patients with chronic illnesses who see many different providers across many different settings. Guided by physicians, this program empowers our members to be in a position to drive their health.

It is confidential and privacy is our highest priority. Additional benefits include personalized care. All of which is overseen by your physician. Our purpose is to support you in navigating your health.

Coordination Services

Adult Program: Chronic Disease Management for CHF, COPD, Diabetes, Hypertension, Heart Disease and Asthma

Pediatric Program: Asthma

Services Provided:

  • Medication review by nurses

  • Locating potential sources for medication assistance

  • Patient education regarding disease processes, medications and potential side effects

  • Communication with health care providers

  • Behavioral change through goal setting

  • Referral to community resources as appropriate

  • Program is a free service for patients

How to Refer:

  • Need patient’s name, DOB, accurate contact information and reason for referral

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